title: Prior Lubrication of the Urethra Does Not Reduce Pain Perception in Men Undergoing Flexible Cystoscopy.
abstract: OBJECTIVE
  The study aimed to test the hypothesis that the instillation of lidocaine gel does not reduce the pain related to flexible cystoscopy.
  
  
  METHODS
  A prospective randomized study was designed to compare the pain perception between intraurethral instillation of lidocaine gel and saline solution in flexible cystoscopy. One hundred consecutive male patients attending for flexible cystoscopy were randomized to receive 10 ml of lidocaine gel or 10 ml of saline solution. Saline solution was also used for the irrigation pressure. Patients recorded their pain on a 10 cm Visual Analog Scale before and after the procedure. Patients also assessed whether the cystoscopy was more painful than the previous one. Statistical comparison was made using the t test for parametrical data and the Mann-Whitney U test for non-parametrical data.
  
  
  RESULTS
  Mean pain score in the lidocaine group was 0.67 ± 1.11 cm (range 0-5) compared to 0.55 ± 1.10 cm (range 0-5) in the saline solution group. Pain perception did not differ significantly between the 2 groups (mean difference 0.12 cm, 95% CI -0.32 to 0.55, p = 0.40).
  
  
  CONCLUSIONS
  Prior lubrication of the urethra does not reduce the pain produced during flexible cystoscopy. The introduction of flexible cystoscopes under direct vision and with an irrigation pressure might guarantee sufficient comfort and the lubricant gel instillation could be avoided.
authors.affiliation: Department of Urology, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Carrion
authors.forename: Eduardo
authors.initials: E
authors.lastname: García-Cruz
authors.forename: Caterina
authors.initials: C
authors.lastname: Fernandez
authors.forename: Maurizio
authors.initials: M
authors.lastname: D'Anna
authors.forename: Anat
authors.initials: A
authors.lastname: Melnick
authors.forename: Lluis
authors.initials: L
authors.lastname: Peri
authors.forename: Agustin
authors.initials: A
authors.lastname: Franco
authors.forename: Antonio
authors.initials: A
authors.lastname: Alcaraz
mesh_terms: D000779:Anesthetics, Local; D003558:Cystoscopy; D005782:Gels; D006801:Humans; D008012:Lidocaine; D008153:Lubrication; D008297:Male; D058748:Pain Perception; D011446:Prospective Studies; D014521:Urethra
chemical_list: D000779:Anesthetics, Local; D005782:Gels; D008012:Lidocaine