Krajewski Wojciech, Kościelska-Kasprzak Katarzyna, Rymaszewska Joanna, Zdrojowy Romuald
Department of Urology and Oncological Urology, Wrocław Medical University, Borowska 213, 50-556, Wrocław, Poland.
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland.
Qual Life Res. 2017 Mar;26(3):625-634. doi: 10.1007/s11136-016-1493-1. Epub 2017 Jan 3.
Bladder cancer (BC) is one of the most common cancers worldwide. BC diagnosis and surveillance is based on cystoscopy (CS). CS impact on patient's depression, anxiety, and sexual satisfaction (SS) is not sufficiently studied. There are no data on patient's comfort with flexible or rigid CS.
We prospectively evaluated pain perception (PP), depression, anxiety, and SS of 100 male patients who previously underwent at least one rigid CS in our department as surveillance after TURB procedure due to non-muscle-invasive BC and were scheduled for the next CS examination. The patients were randomized for flexible or rigid CS. Before CS, patients described their recalled rigid CS-related pain by NRS and fulfilled HADS and SS questionnaires. After CS, PP was re-evaluated immediately and HADS and SS within 7-10 days following the CS.
The baseline scores include 5.2 ± 2.6 points for rigid CS recalled pain, 7.2 ± 3.0 points for HADS anxiety, 5.8 ± 3.5 for depression, and 27.8 ± 5.1 for SS. The flexible CS-related pain was approximately three times lower than the recalled pain level and also than the current rigid CS related (p < 0.001). Mean SS score was two points lowered after rigid CS (p < 0.001). One point decrease in anxiety level was observed after flexible CS (p < 0.001). Multivariate analysis supported the hypothesis of patients benefiting from flexible CS in terms of pain perception, anxiety symptoms, and SS.
Our study demonstrates the superiority of flexible CS in terms of pain alleviation, and shifts in SS and anxiety levels.
膀胱癌（BC）是全球最常见的癌症之一。BC的诊断和监测基于膀胱镜检查（CS）。CS对患者抑郁、焦虑和性满意度（SS）的影响尚未得到充分研究。目前尚无关于患者对软性或硬性CS舒适度的数据。
我们前瞻性评估了100例男性患者的疼痛感知（PP）、抑郁、焦虑和SS，这些患者因非肌层浸润性BC在我们科室接受了至少一次硬性CS作为经尿道膀胱肿瘤切除术（TURB）后的监测，且计划进行下一次CS检查。患者被随机分为接受软性或硬性CS。在CS前，患者通过数字评分量表（NRS）描述其回忆的与硬性CS相关的疼痛，并完成医院焦虑抑郁量表（HADS）和SS问卷。CS后，立即重新评估PP，并在CS后7 - 10天内评估HADS和SS。
基线评分包括：回忆的硬性CS相关疼痛为5.2±2.6分，HADS焦虑为7.2±3.0分，抑郁为5.8±3.5分，SS为27.8±5.1分。与软性CS相关的疼痛比回忆的疼痛水平以及当前与硬性CS相关的疼痛低约三倍（p<0.001）。硬性CS后平均SS评分降低了2分（p<0.001）。软性CS后焦虑水平降低了1分（p<0.001）。多因素分析支持了患者在疼痛感知、焦虑症状和SS方面从软性CS中获益的假设。
我们研究表明，在缓解疼痛、改善SS和焦虑水平方面，软性CS具有优势。
