title: Pain during Female Urethral Catheterization: Intraurethral Lubricant Injection versus Catheter Tip Lubrication--A Prospective Randomized Trial.
abstract: OBJECTIVE
  Urethral lubrication during catheterization can be performed by instilling the gel directly in the urethra or by pouring the gel on the catheter tip. In this study we compared the pain level associated with each technique during female urethral catheterization in the setup of a multichannel urodynamic study.
  
  
  METHODS
  A total of 94 women with a mean ± SD age of 55 ± 14 years who were referred for a multichannel urodynamic study were prospectively randomized into 2 groups according to lubrication technique, including 1) instillation of 5 ml 2% lidocaine gel in the urethra 5 minutes before catheterization or 2) lubrication of the distal part of the catheter with 5 ml 2% lidocaine gel. A visual analog pain scale of 0 to 10 was completed at different time points, including prior to gel instillation (baseline), during gel instillation (group 1), during catheterization, and 5 and 30 minutes after the procedure ended.
  
  
  RESULTS
  The study groups did not differ in demographic, clinical or urodynamic parameters. The mean visual analog scale score during catheterization was 2.3 ± 1.4 and 2.4 ± 1.6 in groups 1 and 2, respectively (p = 0.71). There was no difference in the reported visual analog scale score at the other checkpoints. The mean recorded visual analog scale score during instillation of the lubricant in the urethra in group 1 was 1.9 ± 0.9.
  
  
  CONCLUSIONS
  The actual act of lubricant instillation in the urethra during catheterization in women causes additional and unnecessary pain. Therefore, it is not recommended. Other than that there is no difference in the urethral pain level between the 2 lubrication techniques.
authors.affiliation: Neurourology Division, Department of Urology, Assaf Harofeh Medical Center, Zerifin, Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: stavkobi@gmail.cpm.
authors.forename: Kobi
authors.initials: K
authors.lastname: Stav
authors.affiliation: Neurourology Division, Department of Urology, Assaf Harofeh Medical Center, Zerifin, Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ronny
authors.initials: R
authors.lastname: Ohlgisser
authors.affiliation: Neurourology Division, Department of Urology, Assaf Harofeh Medical Center, Zerifin, Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Yoram I
authors.initials: YI
authors.lastname: Siegel
authors.affiliation: Department of Nephrology, Assaf Harofeh Medical Center, Zerifin, Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ilia
authors.initials: I
authors.lastname: Beberashvili
authors.affiliation: Department of Gynecology, Assaf Harofeh Medical Center, Zerifin, Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Anna
authors.initials: A
authors.lastname: Padoa
authors.affiliation: Neurourology Division, Department of Urology, Assaf Harofeh Medical Center, Zerifin, Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Amnon
authors.initials: A
authors.lastname: Zisman
mesh_terms: D005260:Female; D005782:Gels / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D054327:Lubricants / Q000008:administration & dosage*; D008153:Lubrication; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D059408:Pain Management / Q000379:methods*; D011446:Prospective Studies; D014546:Urinary Catheterization / Q000009:adverse effects*
chemical_list: D005782:Gels; D054327:Lubricants
keywords: catheterization; lubrication; pain; urethra; urodynamics