[Perception of pain in flexible cystoscopy using intraurethral lidocaine]

The aim of this study is to evaluate the efficacy of a local intraurethral anesthetic on the pain perceived by the patient during flexible cystoscopy.

An observational, prospective, nonrandomized, study was conducted on 142 males subjected to a flexible cystoscopy. The patients were divided into two groups: Group 1: 70 patients with intraurethral anesthetic (lidocaine 2%), and Group 2:72 patients without intraurethral anesthetic. The results were scored on a visual analog scale and a pain questionnaire and analyzed. The statistical analysis was performed using SPSS 17.0 and with a statistical significance of p≤0.05.

The mean age of Group 1 was 64.7±10.3 years compared to 66.7±10.8 years in Group 2, with no significant differences. The score on the visual analog scale in Group 1 was 2.23±2.20 versus 1.69±1.74 in Group 2 (p=0.1). The overall and current pain intensity in the pain questionnaire was 1.81±0.87 and 1.66±1.65, respectively, in Group 1, and 1.72±0.72 and 1.21±1.45, respectively, in Group 2 (no significant differences). After dividing the patients into groups according to a visual analog scale score ≤2, it was observed that the cause that led to cystoscopy was an independent factor associated with the perception of pain, increasing the risk of perceiving more pain by 1.89.

The use of local anesthetic as a lubricant prior to flexible cystoscopy does not appear to reduce pain, and we consider that its routine use is not indicated.