I thought this study was interesting because many urologist use MAC anesthesia on these patients while other just use the local.
Published in J Endourol. 2014 Jul 21
Authors: Panach J et al
Objective: flexible cystoscopy is a common practice in urology. We wanted to determine whether a retention time of 5 minutes between the administration of local anesthetic lubricant and flexible cystoscope insertion decreased the degree of discomfort or pain in the patient.
Material and Methods Males who underwent flexible cystoscopy during five months were randomized in a prospective study. They were divided into two groups. In the first one, Cathejell lubricant with lidocaine 12.5g was administered and cystoscopy was performed immediately. In the second one, the same lubricant was maintained in the urethra for 5 minutes before the performance of cystoscopy. After scanning, all the patients were requested to indicate the degree of perceived pain on a visual pain scale from 0 to 10, with 0 being no discomfort and 10 being the maximum degree of pain bearable. As a secondary objective, the relationship of pain to age and to the type of cystoscopist (urologist/resident doctor) was studied. For statistical analysis, a Student’s t test for independent samples and correlation analysis was used.
Results A total of 242 patients were studied, 110 in the immediate group and 132 in the 5-minute-delay group, with samples being homogeneous for age and type of cystoscopist. The mean in the pain scale in the immediate group was 2.41, and in the 5 minutes delay group was 2.04, with no significant differences between them (p = 0.175). There was no relationship with age (r = -0.061, p = 0.348) nor with the type of cystoscopist (2.06 of average pain in the associate group, 2.35 in the resident, p = 0.28).
Conclusions There is no benefit in waiting a short time after the administration of intraurethral lubrication with local anesthetic in flexible cystoscopy in men. There is also no relationship between patient age or the type of cystoscopist (urologist/resident doctor) and perceived pain.