Greenstein Alexander, Greenstein Ithamar, Senderovich Solomon, Mabjeesh Nicola J
Department of Urology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv.
Hebrew University Hadassah Medical School, Jerusalem, Israel.
Int Braz J Urol. 2014 Jul-Aug;40(4):533-8. doi: 10.1590/S1677-5538.IBJU.2014.04.13.
To prospectively evaluate self-reported pain levels associated with diagnostic cystoscopy.
Patients who underwent diagnostic cystoscopy and subsequently graded their pain level during the procedure were enrolled. Pain was graded on a Likert visual analog scale (VAS) of 1-10 where 0 = no pain and 10 = excruciating unbearable pain. Local lidocaine gel 2% was used as intraurethral lubricant.
Data from 1320 consecutive cystoscopies (929 males, 391 females, age range 15-93 years) between 6/2009-1/2010 were analyzed. This was the first cystoscopy for 814 patients. The overall mean VAS was 2.74 ± 1.51 (range 0-9) for rigid cystoscopy and 2.48 ± 1.53 (range 0-10) for flexible cystoscopy (P = 0.004). The reported mean pain level for first-time cystoscopy was significantly higher than that for repeat cystoscopy (2.8 ± 1.6 vs. 2.2 ± 1.4, P < 0.001), regardless of gender or type of cystoscope. Men reported significantly higher pain levels than women 2.6 ± 1.5 vs. 2.4 ± 1.4 (P < 0.04). The highest mean pain level was reported by men (3.4 ± 1.6) and women (2.5 ± 1.6) for rigid cystoscopy compared to flexible cystoscopy (2.5 ± 1.4 and 1.1 ± 1.9, respectively, P < 0.001). Pain levels > 5 were reported in 75 (5.7%) cystoscopies.
Cystoscopy was not associated with distressing levels of pain. Pain levels during first cystoscopies were higher than those for repeated ones. Using a flexible cystoscope is associated with a lower pain level in both men and women and it should be used for both genders.
前瞻性评估与诊断性膀胱镜检查相关的自我报告疼痛程度。
纳入接受诊断性膀胱镜检查并在检查过程中对疼痛程度进行分级的患者。疼痛程度采用1 - 10分的李克特视觉模拟量表（VAS）进行分级，其中0分表示无疼痛，10分表示难以忍受的剧痛。使用2%的局部利多卡因凝胶作为尿道内润滑剂。
分析了2009年6月至2010年1月期间1320例连续膀胱镜检查（929例男性，391例女性，年龄范围15 - 93岁）的数据。这是814例患者的首次膀胱镜检查。硬性膀胱镜检查的总体平均VAS为2.74 ± 1.51（范围0 - 9），软性膀胱镜检查为2.48 ± 1.53（范围0 - 10）（P = 0.004）。无论性别或膀胱镜类型如何，首次膀胱镜检查报告的平均疼痛程度均显著高于重复膀胱镜检查（2.8 ± 1.6对2.2 ± 1.4，P < 0.001）。男性报告的疼痛程度显著高于女性，分别为2.6 ± 1.5和2.4 ± 1.4（P < 0.04）。与软性膀胱镜检查相比，硬性膀胱镜检查中男性（3.4 ± 1.6）和女性（2.5 ± 1.6）报告的平均疼痛程度最高（软性膀胱镜检查中男性和女性分别为2.5 ± 1.4和1.1 ± 1.9，P < 0.001）。75例（5.7%）膀胱镜检查报告的疼痛程度>5分。
膀胱镜检查与令人痛苦的疼痛程度无关。首次膀胱镜检查期间的疼痛程度高于重复检查。使用软性膀胱镜检查时，男性和女性的疼痛程度均较低，男女均应使用。
