ORIGINAL ARTICLES  UROLOGY 

Minerva Urologica e Nefrologica 2016 October;68(5):417-23

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Prospective, multi-institutional pain assessment of 150 women undergoing diagnostic cystoscopy

Stephan SEKLEHNER ¹, Zana SARATLIJA-NOVAKOVIC ², Matthias SKOPEK ³, Harun FAJKOVIC ^{4, 5}, Mesut REMZI ³, Mario DUVNJAK ², Irene RESCH ⁴, Stephan HRUBY ⁶, Wilhelm HÜBNER ³, Davor LIBRENJAK ², Eckart BREINL ⁴, Claus RIEDL ¹, Paul F. ENGELHARDT ¹ ✉

¹ Department of Urology, Landesklinikum Baden-Mödling, Baden, Austria; ² Department of Urology, Klinički Bolnički Centar, Split, Croatia; ³ Department of Urology, Landesklinikum Korneuburg, Korneuburg, Austria; ⁴ Department of Urology, Universitätsklinikum Sankt Pölten, Sankt Pölten, Austria; ⁵ Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria; ⁶ Department of Urology, Paracelsus Medical University Salzburg, Salzburg, Austria

BACKGROUND: The aim of this study was to prospectively assess women’s pain during rigid and flexible diagnostic cystoscopy and afterwards during a one-week follow-up.
METHODS: Prospective, multi-institutional trial analyzing numeric rating scales (NRS) of women undergoing diagnostic cystoscopy. Pain categories: no (0 points), mild (1-3), moderate (4-6) and severe pain (7-10). Assessing of pain before, during cystoscopy, and at day 1, 4 and 7 of follow-up.
RESULTS: A total of 150 women undergoing rigid (N.=85) or flexible (N.=65) diagnostic cystoscopy were analyzed. Women undergoing flexible cystoscopy were more frequently pain-free (64.6% vs. 40%, P=0.003) and experienced mild pain less frequently (27.7% vs. 52.9% vs. P=0.002). No significant differences were noted among moderate (6.2% vs. 5.9%, P=0.95) and severe pain (1.5% vs. 1.2%, P=0.85). Patients undergoing their first (P=0.14) and repeat cystoscopy (P=0.08) had similar pain perception. In multivariate logistic regression analyses, women undergoing flexible cystoscopy had a 2.6 increased chance of being pain-free (OR=2.6, CI: 1.28-5.11, P=0.08) and their odds of experiencing mild pain were significantly lower (OR=0.34, CI: 0.17-0.71, P=0.004). The likelihood of experiencing moderate (OR=1.1, CI: 0.28-4.4, P=0.83) or severe pain (OR=2.42, CI: 0.11-51.79, P=0.57) differed insignificantly.
CONCLUSIONS: Rigid and flexible cystoscopies were well-tolerated by most women. However, flexible cystoscopy was associated with a higher likelihood of being pain-free and lower chances of experiencing mild pain. Patients’ previous experience with cystoscopy did not influence pain perception.