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


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.

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