Investig Clin Urol.  2017 Jan;58(1):48-53. 10.4111/icu.2017.58.1.48.

The effect of office based flexible and rigid cystoscopy on pain experience in female patients

• Casteleijn NF
• Vriesema J
• Stomps SP
• van Balen
• Cornel EB

• KMID: 2365096
• DOI: http://doi.org/10.4111/icu.2017.58.1.48

Abstract

PURPOSE
Rigid and flexible cystoscopies are both routinely used in female patients. Literature is conflicting whether flexible cystoscopy is less painful compared to rigid cystoscopy. The aim of this study was therefore to investigate whether using flexible cystoscopy leads to less discomfort and pain compared to rigid cystoscopy in female patients who underwent first time cystoscopy.
MATERIALS AND METHODS
One hundred eighty-nine female patients, who never had undergone cystoscopy, were randomized into 2 groups: 92 patients underwent rigid cystoscopy and 97 patients flexible cystoscopy. Directly after the cystoscopy procedure all patients were asked to fill out their pain experience on a 100-mm visual analogue pain scale (VAS).
RESULTS
Median VAS score was significantly lower for women undergoing flexible cystoscopy (0 [0-20]) compared to rigid cystoscopy (15 [0-38], p<0.001). In addition, age was inversely associated with VAS score, indicating that younger females experienced more pain (R=−0.30, p=0.001). The use of flexible cystoscopy was associated with a decrease in VAS score and remained significant after adjustment for age, sex of urologist, performing urologist and indication (standardized β=−0.17, p=0.048).
CONCLUSIONS
The use of flexible cystoscopy resulted in a significantly lower pain experience compared to rigid cystoscopy. Based on patient's pain experience during cystoscopy, this study implicates to use flexible cystoscopy in female patients who undergo first time cystoscopy.

Keyword

Cystoscopy; Flexible; Pain experience; Rigid; Women

MeSH Terms

Cystoscopy*
Female*
Humans
Pain Measurement

Figure

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  Fig. 1 Association of age with VAS score, in women with pain during the procedure, stratified for flexible and rigid cystoscopy separately. In patients who underwent rigid cystoscopy VAS score was associated with age (R=−0.35, p=0.004; solid line), whereas a trend was found in patients who underwent flexible cystoscopy (R=−0.23, p=0.075; dashed line).

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