Skip to main content

Advertisement

SpringerLink
Log in

Randomized trial comparing office flexible to rigid cystoscopy in women

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

The objective of the study was to compare office rigid cystoscopy (RC) versus flexible cystoscopy (FC) in women.

Methods

This was a prospective randomized trial comparing FC to RC. Aims were to assess 1-week post-procedural complications, compare procedure pain scores, and to assess physician perception of patient discomfort. Pain scores were assessed by visual analogue scale (VAS) and 5-point verbal descriptor scale (VDS). Chi-square was used for categorical comparison and t tests or Wilcoxon test for continuous variables.

Results

One hundred women were enrolled. The mean age of participants was 59.7 years (± SD 14.6), and 91 % were Caucasian. This was the first cystoscopy for 86 % of participants. On the 1-week post-procedure questionnaire (85 % response rate), participants in the FC group reported urinary frequency more often than in the RC group (p = 0.041). The FC group reported urgency with urination lasting 1–2 days (p = 0.030) and burning with urination lasting >3 days (p = 0.026), more than the RC group. These symptoms did not persist at 7 days. The duration of the procedure was slightly faster for the FC group (4.6 ±1.8 min vs 5.7 ± 3.4 min, p = 0.046). Median VAS scores were 0.9 (0.1–2.72) for the FC group and 0.5 (0–2.4) for the RC group (p = 0.505). There were no significant differences between patient or physician perception of pain in either group.

Conclusions

Urinary frequency and duration of urinary burning post procedure occurred more frequently in the FC group, although these symptoms were transient. Both office FC and RC are generally well tolerated in women with overall low morbidity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Burke DM, Shackley DC, O’Reilly PH (2002) The community-based morbidity of flexible cystoscopy. BJU Int 89(4):347–349

    Article  PubMed  CAS  Google Scholar 

  2. Denholm SW, Conn IG, Newsam JE, Chisholm GD (1990) Morbidity following cystoscopy: comparison of flexible and rigid techniques. Br J Urol 66(2):152–154

    Article  PubMed  CAS  Google Scholar 

  3. Goldfischer ER, Cromie WJ, Karrison TG, Naszkiewicz L, Gerber GS (1997) Randomized, prospective, double-blind study of the effects on pain perception of lidocaine jelly versus plain lubricant during outpatient rigid cystoscopy. J Urol 157(1):90–94

    Article  PubMed  CAS  Google Scholar 

  4. Patel AR, Jones JS, Angie S, Babineau D (2007) Office based flexible cystoscopy may be less painful for men allowed to view the procedure. J Urol 177(5):1843–1845. doi:10.1016/j.juro.2007.01.070

    Article  PubMed  Google Scholar 

  5. Patel AR, Jones JS, Babineau D (2008) Impact of real-time visualization of cystoscopy findings on procedural pain in female patients. J Endourol 22(12):2695–2698. doi:10.1089/end.2008.0076

    Article  PubMed  Google Scholar 

  6. Stein M, Lubetkin D, Taub HC, Skinner WK, Haberman J, Kreutzer ER (1994) The effects of intraurethral lidocaine anesthetic and patient anxiety on pain perception during cystoscopy. J Urol 151(6):1518–1521

    PubMed  CAS  Google Scholar 

  7. Barber MD, Walters MD, Bump RC (2005) Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol 193(1):103–113

    Article  PubMed  CAS  Google Scholar 

  8. Huskisson EC, Sturrock RD, Tugwell P (1983) Measurement of patient outcome. Br J Rheumatol 22(3 Suppl):86–89

    PubMed  CAS  Google Scholar 

  9. Melzack R (1975) The McGill Pain Questionnaire: major properties and scoring methods. Pain 1(3):277–299

    Article  PubMed  CAS  Google Scholar 

  10. Denholm SW, Conn IG, Newsam JE, Chisholm GD (1990) Morbidity following cystoscopy: comparison of flexible and rigid techniques. Br J Urol 66(2):152–154

    Article  PubMed  CAS  Google Scholar 

  11. Flannigan GM, Gelister JS, Noble JG, Milroy EJ (1988) Rigid versus flexible cystoscopy. A controlled trial of patient tolerance. Br J Urol 62(6):537–540

    Article  PubMed  CAS  Google Scholar 

  12. Clayman RV, Reddy P, Lange PH (1984) Flexible fiberoptic and rigid-rod lens endoscopy of the lower urinary tract: a prospective controlled comparison. J Urol 131(4):715–716

    PubMed  CAS  Google Scholar 

  13. Walker L, Liston TG, RW LL-D (1993) Does flexible cystoscopy miss more tumours than rod-lens examination? Br J Urol 72(4):449–450

    Article  PubMed  CAS  Google Scholar 

  14. Rané A, Cahill D, Saleemi A, Montgomery B, Palfrey E (2001) The issue of prophylactic antibiotics prior to flexible cystoscopy. Eur Urol 39(2):212–214

    Article  PubMed  Google Scholar 

  15. Manson AL (1988) Is antibiotic administration indicated after outpatient cystoscopy. J Urol 140(2):316–317

    PubMed  CAS  Google Scholar 

  16. Wilson L, Ryan J, Thelning C, Masters J, Tuckey J (2005) Is antibiotic prophylaxis required for flexible cystoscopy? A truncated randomized double-blind controlled trial. J Endourol 19(8):1006–1008. doi:10.1089/end.2005.19.1006

    Article  PubMed  CAS  Google Scholar 

  17. Gee JR, Waterman BJ, Jarrard DF, Hedican SP, Bruskewitz RC, Nakada SY (2009) Flexible and rigid cystoscopy in women. JSLS 13(2):135–138

    PubMed  Google Scholar 

  18. Chen YT, Hsiao PJ, Wong WY, Wang CC, Yang SS, Hsieh CH (2005) Randomized double-blind comparison of lidocaine gel and plain lubricating gel in relieving pain during flexible cystoscopy. J Endourol 19(2):163–166. doi:10.1089/end.2005.19.163

    Article  PubMed  Google Scholar 

  19. Fowler CG, Badenoch DF, Thakar DR (1984) Practical experience with flexible fibrescope cystoscopy in out-patients. Br J Urol 56(6):618–621

    Article  PubMed  CAS  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA

    Lieschen H. Quiroz, S. Abbas Shobeiri, Mikio A. Nihira & Jordan Brady

  2. Reproductive Endocrinology & Epidemiology, Women’s Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA

    Robert A. Wild

  3. Division Female Pelvic Medicine and Reconstructive Surgery, University of Oklahoma Health Sciences Center, 920 S. L. Young, WP 2430, Oklahoma City, OK, 73104, USA

    Lieschen H. Quiroz

Authors
  1. Lieschen H. Quiroz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Abbas Shobeiri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mikio A. Nihira
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jordan Brady
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Robert A. Wild
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lieschen H. Quiroz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Quiroz, L.H., Shobeiri, S.A., Nihira, M.A. et al. Randomized trial comparing office flexible to rigid cystoscopy in women. Int Urogynecol J 23, 1625–1630 (2012). https://doi.org/10.1007/s00192-012-1777-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-012-1777-0

Keywords

Search

Navigation