The superiority of the analgesic effect of intraurethral Bupivacaine during outpatient flexible cystoscopy in male patients

Objective

Flexible cystoscopy (FC) has become a frequently applied outpatient prosedure. Dysuria with an incidence of 30–54% is the main complaint of patients. As our hypothesis was, lower pain scores during and after cystoscopy would be achieved with bupivacaine application we aimed to compare the analgesic efficacy of intraurethral bupivacaine and lidocaine.

Subjects and methods

Files of 90 patients who underwent FC in our clinic, between August 2015 and November 2015 were retrospectively scanned. Patients were evaluated in 2 groups according to the local anesthetic they were applied intraurethrally. The first group consisted of 45 patients who received 10 mL of %2 lidocaine gel; the second group consisted of 45 patients who received 10 mL of 0.5% bupivacaine. A numerical visual analog scale (VAS) from 0 to 10 was used to assess pain scores during and after the procedure.

Results

During the procedure the mean VAS was 4.09 (±1.95) in the %2 lidocaine group and 4.3 (±1.58) in the 0.5% bupivacaine group (p = .5). Therefore, during the first micturition after the procedure the mean VAS was 3.4 (±1.86) in the %2 lidocaine group and 2.09 (±1.19) in the 0.5% bupivacaine group (<0.001).

Conclusions

With the reason that dyuria is the most annoying complication for the patients undergoing FC, it is worth trying to overcome this issue. By providing significantly decreased levels of dysuria, 0.5% bupivacaine was superior to %2 lidocaine gel for local analgesia especially during first micturiation after out-patient FC in males patients.