title: Assessment of efficacy of transcutaneous electrical nerve stimulation for pain management during office-based flexible cystoscopy.
abstract: OBJECTIVE
  To evaluate the efficacy of transcutaneous electrical nerve stimulation (TENS) for its effectiveness in eliminating or minimizing discomfort during office-based flexible cystoscopy.
  
  
  METHODS
  A total of 148 patients were prospectively randomized into one of three groups: flexible cystoscopy with no analgesics, a placebo TENS, or an activated TENS. The patient data collected included patient parameters, number of previous flexible cystoscopies, visual analog pain scores during and after the procedure, surgeon's difficulty rating of procedure, and International Prostate Symptom Score before and 24 hours after the procedure.
  
  
  RESULTS
  No statistically significant difference was found among the three groups regarding patient parameters. The visual analog pain scores were similar before and after the procedure. At 30 seconds, the mean visual analog scale score for the control group, placebo group, and TENS study group was 3.73, 3.65, and 3.52, respectively (control versus placebo, control versus active, and placebo versus active: P = 0.97, 0.29, and 0.53, respectively). At 1 and 5 minutes, the corresponding scores were 3.44, 4.37, and 3.50 (P = 0.88, P = 0.99, and P = 0.99) and 0.86, 1.23, and 0.88 (P = 0.97, P = 0.35, and P = 0.56), respectively. The surgeon's mean difficulty rating for the control procedures was 1.08 and for the placebo group was 2.30 (P = 0.02).
  
  
  CONCLUSIONS
  All patients undergoing flexible cystoscopy in the office setting experienced discomfort. The TENS device provided no significant benefit for pain. The trend toward greater pain scores in the control group could be attributed to the greater degree of difficulty.
authors.affiliation: Department of Urology, Columbia University School of Medicine, New York, New York 10032, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Hruby
authors.forename: Caroline
authors.initials: C
authors.lastname: Ames
authors.forename: Cathy
authors.initials: C
authors.lastname: Chen
authors.forename: Yan
authors.initials: Y
authors.lastname: Yan
authors.forename: James
authors.initials: J
authors.lastname: Sagar
authors.forename: Pam
authors.initials: P
authors.lastname: Baron
authors.forename: Jaime
authors.initials: J
authors.lastname: Landman
mesh_terms: D000556:Ambulatory Surgical Procedures; D003558:Cystoscopy / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D059408:Pain Management; D010147:Pain Measurement; D011446:Prospective Studies; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome