LAUSR

PURPOSE Determine if "bag-squeeze" technique decreases pain during flexible cystoscopy in men. METHODS AND MATERIALS A single center, prospective, double-blinded randomized controlled trial recruiting 200 consenting participants who were ambulatory, outpatient males who had undergone a prior cystoscopy and were not expected to require any secondary procedures. Men with prior urethral stricture or bladder neck contracture were excluded. Once eligibility was assessed and consent obtained, participants were randomized to undergo cystoscopy with the "bag-squeeze" (group A) or the sham bag-squeeze procedure (group B). Following the cystoscopy, participants completed a pain questionnaire: visual analogue scale. Differences in mean pain score between groups were evaluated using a Students T test with two-sided alpha of 0.05. RESULTS Two hundred patients were randomized and underwent flexible cystoscopy. Ten participants were ineligible because they required secondary procedures. Among the 190 eligible patients, 97 were randomized to bag-squeeze (group A) and 93 to sham bag-squeeze (group B) with mean pain scores of 1.91 and 3.39, respectively. (p<0.005). CONCLUSION This study demonstrated a clinically meaningful decrease in pain for men undergoing flexible cystoscopy when the irrigation "bag-squeeze" technique was employed versus placebo bag-squeeze. Accordingly, this useful, simple and free method to improve patient comfort during flexible cystoscopy should be adopted by clinicians.Patient Summary:Squeezing the irrigation bag during a flexible cystoscopy improves pain perception by males and we recommend this to be the standard of care.