Pressure Makes Pleasure: A Preliminary Study of Increasing Irrigation Pressure of Flexible Cystoscopy Improves Male Patient Comfort by an Easy Way

Objective: To evaluate the impact of increasing irrigation pressure when performing flexible cystoscopy for male patients on visual analog scale pain scores. Patients and Methods: A total of 168 male patients admitted to our clinic for flexile cystoscopy by the same urologist between March 2011 and December 2012 were randomized to three equal groups, each of which had 56 patients. Different irrigation pressures were easily achieved by adjusting the height of irrigation solution bag (1000mL of 0.9% saline). The height difference between the bag and the bed (for cystoscopy) of group 1, 2, and 3 was 80, 100, and 150cm, respectively. All patients received 10mL lidocaine gel for 3 minutes for local anesthesia before flexible cystoscopy. Patients' pain feeling was recorded on a visual analog scale (VAS) ranging from 0 to 10 after the cystoscopy. The duration of the procedure for each patient was also recorded. Results: The mean pain score on VAS was 2.951.31, 2.48 +/- 1.26, and 1.66 +/- 1.00 in group 1, 2, and 3, respectively. Compared to group 1 and 2, the mean pain score was significantly lower in group 3 (p<0.001, Mann-Whitney U-test), and the mean pain score in group 2 was statistically significantly lower than that in group 1 (p=0.045, Mann-Whitney U-test). Patients who were with high irrigation pressure experienced less discomfort at cystoscopy. Patient age and duration of the procedure for each group were comparable. Conclusion: Achieving higher irrigation pressure for flexible cystoscopy by adjusting the height of irrigation solution bag improves male patients' comfort. It is recommended for male patients.