title: Does sodium bicarbonate reduce painful voiding after flexible cystoscopy? A prospective, randomized, double-blind, controlled trial.
abstract: OBJECTIVE
  • To determine if sodium bicarbonate (Ural) reduces painful voiding after flexible cystoscopy.
  
  
  METHODS
  • 300 patients over 18 years old undergoing elective flexible cystoscopy were enrolled in a randomized, double-blinded, placebo-controlled trial. Patients with active urinary tract infections, indwelling urinary catheters and/or requiring additional procedures such as biopsy and dilatation were excluded. • Painful voiding was quantified using a pain analogue scale from 0 to 10. Pre-existing painful voiding, previous experience with Ural and flexible cystoscopy were recorded. • Flexible cystoscopy was performed to a standard protocol. Patients were randomised after recruitment to receive Ural or placebo (glucose) powder four times a day for two days after the procedure. Trial outcome was assessed by estimating the change in pain incidence and severity from before to two days after by post-procedural questionnaire.
  
  
  RESULTS
  • Painful voiding was present in 84 of the 300 patients post flexible cystoscopy (45 of 160 patients receiving Ural; 39 of 140 receiving placebo), but overall mean pain scores were low (1.25; standard deviation 2.4; on a 0-10 scale). • Treatment with Ural compared to placebo was associated with a non-significant reduction in frequency of pain (28.9% vs 31.3%; incidence rate ratio 0.66; 95% CI 0.29-1.46; P = 0.30) and severity of pain (odds ratio 0.72; 95% CI 0.30-1.74; P = 0.47).
  
  
  CONCLUSIONS
  •In the replicable context of low post-cystoscopy pain levels, we believe Ural does not reduce painful voiding after flexible cystoscopy.
authors: Department of Urology, Launceston General Hospital, Launceston, Australia. lihmingwong@gmail.com
authors: Lih-Ming
authors: LM
authors: Wong
authors: James G
authors: JG
authors: Huang
authors: Tuck L
authors: TL
authors: Yong
authors: Iain
authors: I
authors: Robertson
authors: Stephen J S
authors: SJ
authors: Brough
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003558:Cystoscopy / Q000009:adverse effects* / Q000379:methods; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010147:Pain Measurement; D011183:Postoperative Complications / Q000188:drug therapy*; D011446:Prospective Studies; D017693:Sodium Bicarbonate / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014554:Urination; D055815:Young Adult
chemical_list: D017693:Sodium Bicarbonate