title: Patient comfort during flexible and rigid cystourethroscopy.
abstract: BACKGROUND
  Cystourethroscopy (CS) is an endoscopic method used to visualize the urethra and the bladder.
  
  
  OBJECTIVE
  In this study, we prospectively evaluated pain in men undergoing cyclic cystoscopic assessment with rigid and flexible instruments after transurethral resection of bladder tumor (TURB).
  
  
  METHODS
  One hundred and twenty male patients who were under surveillance after a TURB procedure due to urothelial cell carcinoma and who had undergone at least one rigid cystourethroscopy in the past were enrolled in the trial. Patients were prospectively randomized to age-matched groups for flexible (group F) or rigid (group R) CS. Patient's comfort was evaluated on an 11-grade scale, ranging from 0 (free from pain) to 10 points (unbearable pain).
  
  
  RESULTS
  The patients described the pain during the previous rigid CS as ranging from 4 to 10 (mean: 6.8) in group F and from 0 to 10 (mean: 5.8) in group R. Group R patients described the pain during the current rigid CS as ranging from 0 to 10 (mean: 5.7). No mean change in the grade was observed between the two pain descriptions (no change 11 patients, weaker pain 25 patients, stronger pain 24 patients, gamma 0.51, p < 0.0001). Group F described the pain as 1 to 5 (mean: 2.1). In the case of flexible CS the pain experience was greatly lowered compared to the previous rigid CS. All flexible CS patients reported lowered pain (by 1 to 9 grades). Patients' age did not influence the comfort of the flexible CS or the change in pain level.
  
  
  CONCLUSIONS
  Flexible CS is better tolerated than rigid cystoscopy by male patients regardless of patients' age.
authors.affiliation: Department of Urology and Oncological Urology, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Krajewski
authors.affiliation: Department of Urology and Oncological Urology, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Romuald
authors.initials: R
authors.lastname: Zdrojowy
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Wojciechowska
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kościelska
authors.affiliation: Department of Urology and Oncological Urology, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Dembowski
authors.affiliation: Department of Urology and Oncological Urology, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Matuszewski
authors.affiliation: Department of Urology and Oncological Urology, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Tupikowski
authors.affiliation: Department of Urology and Oncological Urology, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Bartosz
authors.initials: B
authors.lastname: Małkiewicz
authors.affiliation: Department of Urology and Oncological Urology, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Kołodziej
keywords: flexible cystoscopy; pain; rigid cystoscopy