title: Is a retention time after the instillation of anesthetic lubricant necessary when performing male flexible cystoscopy?
abstract: OBJECTIVE
  Flexible cystoscopy is a common practice in urology. We wanted to determine whether a retention time of 5 minutes between the administration of a local anesthetic lubricant and flexible cystoscope insertion decreased the degree of discomfort or pain in the patient.
  
  
  METHODS
  Males who underwent flexible cystoscopy during 5 months were randomized in a prospective study. They were divided into two groups. In the first one, the Cathejell lubricant with lidocaine 12.5 g was administered and cystoscopy was performed immediately. In the second one, the same lubricant was maintained in the urethra for 5 minutes before the performance of cystoscopy. After scanning, all the patients were requested to indicate the degree of perceived pain on a visual pain scale from 0 to 10, with 0 being no discomfort and 10 being the maximum degree of pain bearable. As a secondary objective, the relationship of pain to age and to the type of cystoscopist (urologist/resident doctor) was studied. For statistical analysis, a Student's t-test for independent samples and correlation analysis were used.
  
  
  RESULTS
  A total of 242 patients were studied, 110 in the immediate group and 132 in the 5-minute delay group, with samples being homogeneous for the age and type of cystoscopist. The mean in the pain scale in the immediate group was 2.41, and in the 5-minute delay group was 2.04, with no significant differences between them (p=0.175). There was no relationship with age (r=-0.061, p=0.348) or with the type of cystoscopist (2.06 of average pain in the associate group, 2.35 in the resident, p=0.28).
  
  
  CONCLUSIONS
  There is no benefit in waiting a short time after the administration of intraurethral lubrication with a local anesthetic in flexible cystoscopy in men. There is also no relationship between the patient age or the type of cystoscopist (urologist/resident doctor) and perceived pain.
authors.affiliation: Department of Urology, University Clinic Hospital of Valencia , Valencia, Spain .
authors.forename: Jorge
authors.initials: J
authors.lastname: Panach-Navarrete
authors.forename: Jose María
authors.initials: JM
authors.lastname: Martínez-Jabaloyas
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002983:Clinical Competence; D003558:Cystoscopy / Q000379:methods*; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D054327:Lubricants / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D011300:Preoperative Care; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D054327:Lubricants; D008012:Lidocaine