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Impact of Patient-Controlled Bag Squeeze on Pain and Anxiety in Male Patients Undergoing Flexible Cystoscopy: A
Atsushi Wanifuchi1, Toshiaki Tanaka2, Ippei Muranaka1
1Department of Urology, Japanese Red Cross Kushiro Hospital, Kushiro, Japan.
Introduction:
The aim of this randomized control trial is to evaluate the effect of patient-controlled irrigation on pain and anxiety during outpatient flexible cystoscopy in male patients.
Materials And Methods:
From April to June 2025, a prospective, double-blind randomized controlled trial was conducted. Male outpatients undergoing diagnostic flexible cystoscopy were randomly allocated to either squeeze a functioning water bag connected to the irrigation system (patient-controlled bag squeeze group) or a disconnected sham bag (standard irrigation group). The primary outcome was Visual Analogue Scale for pain. Secondary outcomes included changes in the State-Trait Anxiety Inventory, Visual Analogue Scale for satisfaction, physiological metrics, and patient preference regarding self-involvement in bag squeezing.
Results:
A total of 50 patients were randomized to the patient-controlled bag squeeze (n = 24) or standard irrigation (n = 26) group. Baseline characteristics were similar between groups. The patient-controlled bag squeeze group demonstrated significantly higher irrigation volume and flow rate, with no difference in procedure duration. Pain scores were significantly lower (p = 0.0001) and satisfaction scores higher (p = 0.006) in the patient-controlled bag squeeze group. A significantly greater proportion of patients in the patient-controlled bag squeeze group reported a favorable preference for the intervention (p = 0.002). No differences were seen in physiological measures or anxiety reduction, and no infections occurred.
Conclusions:
Patient-controlled bag squeeze appears to be a safe and effective analgesia method comparable to caregiver-assisted methods, and demonstrates favorable patient preference.
Trial Registration:
University Hospital Medical Information Network clinical trials registry, Japan: UMIN000057485.
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