Krajewski Wojciech, Zdrojowy Romuald, Wojciechowska Joanna, Kościelska Katarzyna, Dembowski Janusz, Matuszewski Michał, Tupikowski Krzysztof, Małkiewicz Bartosz, Kołodziej Anna
Department of Urology and Oncological Urology, Wroclaw Medical University, Wroclaw, Poland.
Department of Otolaryngology and Head and Neck Surgery, Wroclaw Medical University, Wroclaw, Poland.
Wideochir Inne Tech Maloinwazyjne. 2016;11(2):94-7. doi: 10.5114/wiitm.2016.60665. Epub 2016 Jun 17.
Cystourethroscopy (CS) is an endoscopic method used to visualize the urethra and the bladder.
In this study, we prospectively evaluated pain in men undergoing cyclic cystoscopic assessment with rigid and flexible instruments after transurethral resection of bladder tumor (TURB).
One hundred and twenty male patients who were under surveillance after a TURB procedure due to urothelial cell carcinoma and who had undergone at least one rigid cystourethroscopy in the past were enrolled in the trial. Patients were prospectively randomized to age-matched groups for flexible (group F) or rigid (group R) CS. Patient's comfort was evaluated on an 11-grade scale, ranging from 0 (free from pain) to 10 points (unbearable pain).
The patients described the pain during the previous rigid CS as ranging from 4 to 10 (mean: 6.8) in group F and from 0 to 10 (mean: 5.8) in group R. Group R patients described the pain during the current rigid CS as ranging from 0 to 10 (mean: 5.7). No mean change in the grade was observed between the two pain descriptions (no change 11 patients, weaker pain 25 patients, stronger pain 24 patients, gamma 0.51, p < 0.0001). Group F described the pain as 1 to 5 (mean: 2.1). In the case of flexible CS the pain experience was greatly lowered compared to the previous rigid CS. All flexible CS patients reported lowered pain (by 1 to 9 grades). Patients' age did not influence the comfort of the flexible CS or the change in pain level.
Flexible CS is better tolerated than rigid cystoscopy by male patients regardless of patients' age.
膀胱尿道镜检查（CS）是一种用于观察尿道和膀胱的内镜检查方法。
在本研究中，我们前瞻性评估了经尿道膀胱肿瘤切除术（TURB）后使用刚性和柔性器械进行周期性膀胱镜评估的男性患者的疼痛情况。
120名因尿路上皮细胞癌接受TURB手术后处于监测期且过去至少接受过一次刚性膀胱尿道镜检查的男性患者纳入试验。患者被前瞻性随机分为年龄匹配的柔性（F组）或刚性（R组）CS组。患者的舒适度采用11级评分，范围从0分（无疼痛）到10分（难以忍受的疼痛）。
F组患者将之前刚性CS期间的疼痛描述为4至10分（平均：6.8分），R组为0至10分（平均：5.8分）。R组患者将当前刚性CS期间的疼痛描述为0至10分（平均：5.7分）。两次疼痛描述之间未观察到平均分级变化（无变化11例患者，疼痛减轻25例患者，疼痛加重24例患者，伽马值0.51，p<0.0001）。F组将疼痛描述为1至5分（平均：2.1分）。在柔性CS的情况下，与之前的刚性CS相比，疼痛体验大大降低。所有柔性CS患者均报告疼痛减轻（减轻1至9级）。患者年龄不影响柔性CS的舒适度或疼痛水平变化。
无论患者年龄如何，男性患者对柔性CS的耐受性均优于刚性膀胱镜检查。
