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PubMed2003

A comparison of anticipated pain before and pain rating after the procedure in patients who undergo cystourethroscopy.

OBJECTIVE: The purpose of this study was to compare anticipated pain before the procedure and actual pain rating after the procedure in female patients who undergo cystourethroscopy. STUDY DESIGN: Eighty-seven consecutive female patients completed a 10-cm visual analog pain scale before and after cystourethroscopy. A 24F urethroscope was used initially to inspect the urethra and was followed by a systematic survey of the bladder with a 17F cystoscope that was lubricated with 2% lidocaine gel. The visual analog pain scale scores were evaluated for significance with the use of the Student t test and the Pearson correlation coefficient. RESULTS: Visual analog pain scale analysis demonstrated a mean anticipated pain score of 3.75 cm before the procedure versus a mean pain rating score of 2.83 cm after the procedure (P <.05). Neither a history of previous cystoscopy (visual analog pain scale score, 3.03 vs 2.30 cm; P =.18) nor talking with someone about the procedure beforehand (visual analog pain scale score, 2.74 vs 2.89 cm; P =.76) influenced the lower pain rating after the procedure. There was no significant correlation between age, parity, body mass index, or presence of pelvic organ prolapse and anticipated or realized pain perception. CONCLUSION: Patients who undergo cystourethroscopy consistently anticipate higher degrees of discomfort than they actually perceive during the procedure.

Analgesics↗

PubMed2003

Management of obstructive voiding dysfunction.

Voiding dysfunction may be defined as difficulty in the volitional emptying of the bladder in an efficient and controlled manner that can extend from a spectrum of minor irritative symptoms to complete retention. Resolution of symptoms can be accomplished by correctly identifying the underlying pathology and directing therapy appropriately to restore function and anatomy. Causes and treatments of obstructive voiding dysfunction tend to be gender specific. In approximately one-half of women, the causes of obstructive voiding dysfunction are prior anti-incontinence surgery and pelvic organ prolapse, which will usually lead to a surgical intervention. For men, benign prostate disease is the overwhelming cause of obstructive voiding. Due to its increasing prevalence in the aging male population, a variety of treatments--pharmacological and operative--have been developed, with more on the horizon. This review addresses a wide variety of treatments for the numerous conditions causing obstructive voiding dysfunction in men and women, all of them with the goal in mind of resolve the patient's symptoms without creating de novo pathology.

Clinical Trials as Topic↗