Impact of real-time visualization of cystoscopy findings on procedural pain in female patients

Abstract

BACKGROUND AND PURPOSE: We have previously shown that men tolerate office flexible cystoscopy better when they simultaneously view the monitor during their procedure. We sought to demonstrate similar effects of distraction on women undergoing rigid office cystoscopy.

PATIENTS AND METHODS: 100 consecutive women underwent diagnostic office based rigid cystoscopy. All patients consented to inclusion in the study. Patients were randomized to two groups. The study group consisted of patients who were allowed to view their procedure real-time on the video monitor. The control group patients had the video screen positioned such that only the surgeon could visualize the procedure. Patients underwent rigid cystoscopy using a 17F cystoscope introduced with an obturator. Water-soluble lubricant was liberally applied to all cystoscopes immediately before the procedure. Patients who needed additional procedures, including cystodiathermy or stent extraction, were excluded from the study groups. Postprocedure, patients were asked to record their experience on a 100-mm visual analog pain scale as soon as the surgeon left the room.

RESULTS: Women who were able to view their cystoscopy findings simultaneously during the procedure did not demonstrate lower pain scores compared with those who did not view the screen (median pain score of 19 v 10; P = 0.16, based on Wilcoxon rank sum test).

CONCLUSIONS: In contrast to the decreased pain scores demonstrated when tested in men, use of distraction by allowing patients to simultaneous view their procedure may not affect procedure tolerance for women undergoing office-based rigid cystoscopy.