Prospective Evaluation of Anxiety, Pain, and Embarrassment Associated with Cystoscopy and Urodynamic Testing in Clinical Practice

Overview

Journal Can Urol Assoc J

Specialty Urology

Date 2017 May 19

PMID 28515809

Citations 23

Authors

Xavier Biardeau

Ornella Lam

Van Ba

Lysanne Campeau

Jacques Corcos

Affiliations

Soon will be listed here.

Abstract

Introduction: We sought to prospectively assess anxiety, pain, and embarrassment associated with diagnostic cystoscopy and multi-channel urodynamic study (UDS).

Methods: All consecutive patients undergoing diagnostic cystoscopy or UDS in our department over a period of nine months were asked to participate. Two anonymous auto-administered questionnaires were specifically designed to collect basic epidemiological data, document medical history, and assess the quality of information provided, along with prevalence and level (010 numerical visual analog rating scale) of anxiety, pain, and embarrassment experienced before and/or during the procedures. Statistical analysis was carried out to identify underlying factors that could have influenced patients' experience and ascertain potential correlations between anxiety, pain, and embarrassment.

Results: 101 and 185 patients were respectively evaluated immediately after cystoscopy and UDS. Multivariate analysis repeatedly showed statistical correlations between anxiety, pain, and embarrassment, with regard to prevalence and level of intensity in both cystoscopy and UDS populations. Males and young patients were more likely to present anxiety, pain, or embarrassment during cystoscopy and UDS. Interestingly, patients who reported having received complete information before cystoscopy were significantly more likely to experience anxiety (62.6% vs. 20.0%; p=0.009).

Conclusions: The present study demonstrated the major impact of gender and age on patients' experience. Interestingly, information provided before cystoscopy was reported to have a negative impact on patients' perception of anxiety; this could be partly prevented by optimizing the way information is provided to patients.

Citing Articles

Readability of Online Patient-Directed Content About Cystoscopy and Urodynamic Testing.

Jain M, Stairs J, Sorgini A, Clancy A Int Urogynecol J. 2025; .

PMID: 40067508 DOI: 10.1007/s00192-025-06100-6.

Artificial intelligence assisted patient blood and urine droplet pattern analysis for non-invasive and accurate diagnosis of bladder cancer.

Demir R, Koc S, Ozturk D, Bilir S, Ozata H, Williams R Sci Rep. 2024; 14(1):2488.

PMID: 38291121 PMC: 10827787. DOI: 10.1038/s41598-024-52728-7.

Quality of care perceived by patients during cystoscopy and affecting factors.

Saray Kilic H, Pazar B, Ibrahimoglu O, Naldan M Medicine (Baltimore). 2023; 102(50):e36314.

PMID: 38115337 PMC: 10727613. DOI: 10.1097/MD.0000000000036314.

One-Pot Analytical Pipeline for Efficient and Sensitive Proteomic Analysis of Extracellular Vesicles.

Liu Y, Wu X, Hadisurya M, Li L, Kaimakliotis H, Iliuk A J Proteome Res. 2023; 22(10):3301-3310.

PMID: 37702715 PMC: 10897859. DOI: 10.1021/acs.jproteome.3c00361.

Protein Biomarker Discovery Studies on Urinary sEV Fractions Separated with UF-SEC for the First Diagnosis and Detection of Recurrence in Bladder Cancer Patients.

Jordaens S, Oeyen E, Willems H, Ameye F, De Wachter S, Pauwels P Biomolecules. 2023; 13(6).

PMID: 37371512 PMC: 10296596. DOI: 10.3390/biom13060932.

References

Yokoyama T, Nozaki K, Nose H, Inoue M, Nishiyama Y, Kumon H . Tolerability and morbidity of urodynamic testing: a questionnaire-based study. Urology. 2005; 66(1):74-6. DOI: 10.1016/j.urology.2005.01.027. View

Komiya A, Endo T, Kobayashi M, Kim W, Araki K, Naya Y . Oral analgesia by non-steroidal anti-inflammatory drug zaltoprofen to manage cystoscopy-related pain: a prospective study. Int J Urol. 2009; 16(11):874-80. DOI: 10.1111/j.1442-2042.2009.02384.x. View

Greenstein A, Greenstein I, Senderovich S, Mabjeesh N . Is diagnostic cystoscopy painful? Analysis of 1,320 consecutive procedures. Int Braz J Urol. 2014; 40(4):533-8. DOI: 10.1590/S1677-5538.IBJU.2014.04.13. View

Ellerkmann R, Dunn J, McBride A, Kummer L, Melick C, Bent A . A comparison of anticipated pain before and pain rating after the procedure in patients who undergo cystourethroscopy. Am J Obstet Gynecol. 2003; 189(1):66-9. DOI: 10.1067/mob.2003.377. View

Yeo J, Cho D, Oh M, Park S, Park M . Listening to music during cystoscopy decreases anxiety, pain, and dissatisfaction in patients: a pilot randomized controlled trial. J Endourol. 2012; 27(4):459-62. PMC: 3624627. DOI: 10.1089/end.2012.0222. View

Stav K, Leibovici D, Goren E, Livshitz A, Siegel Y, Lindner A . Adverse effects of cystoscopy and its impact on patients' quality of life and sexual performance. Isr Med Assoc J. 2004; 6(8):474-8. View

Lang E, Hatsiopoulou O, Koch T, Berbaum K, Lutgendorf S, Kettenmann E . Can words hurt? Patient-provider interactions during invasive procedures. Pain. 2005; 114(1-2):303-9. DOI: 10.1016/j.pain.2004.12.028. View

Yeung J, Eschenbacher M, Pauls R . Pain and embarrassment associated with urodynamic testing in women. Int Urogynecol J. 2013; 25(5):645-50. DOI: 10.1007/s00192-013-2261-1. View

Morgan M, Dodds W, Wolfe C, Raju S . Women's views and experiences of outpatient hysteroscopy: implications for a patient-centered service. Nurs Health Sci. 2004; 6(4):315-20. DOI: 10.1111/j.1442-2018.2004.00202.x. View

10.

Goldfischer E, Cromie W, Karrison T, Naszkiewicz L, Gerber G . Randomized, prospective, double-blind study of the effects on pain perception of lidocaine jelly versus plain lubricant during outpatient rigid cystoscopy. J Urol. 1997; 157(1):90-4. View

11.

Yerlikaya G, Laml T, Elenskaia K, Hanzal E, Kolbl H, Umek W . Pain perception during outpatient cystoscopy: a prospective controlled study. Eur J Obstet Gynecol Reprod Biol. 2013; 173:101-5. DOI: 10.1016/j.ejogrb.2013.11.007. View

12.

Patel A, Stephen Jones J, Babineau D . Impact of real-time visualization of cystoscopy findings on procedural pain in female patients. J Endourol. 2008; 22(12):2695-8. DOI: 10.1089/end.2008.0076. View

13.

Stein M, Lubetkin D, Taub H, Skinner W, HABERMAN J, Kreutzer E . The effects of intraurethral lidocaine anesthetic and patient anxiety on pain perception during cystoscopy. J Urol. 1994; 151(6):1518-21. DOI: 10.1016/s0022-5347(17)35290-4. View

14.

Eberhardt J, van Wersch A, Van Schaik P, Cann P . Information, social support and anxiety before gastrointestinal endoscopy. Br J Health Psychol. 2006; 11(Pt 4):551-9. DOI: 10.1348/135910705X72514. View

15.

Aaronson D, Walsh T, Smith J, Davies B, Hsieh M, Konety B . Meta-analysis: does lidocaine gel before flexible cystoscopy provide pain relief?. BJU Int. 2009; 104(4):506-9. DOI: 10.1111/j.1464-410X.2009.08417.x. View

16.

Scarpero H, Padmanabhan P, Xue X, Nitti V . Patient perception of videourodynamic testing: a questionnaire based study. J Urol. 2005; 173(2):555-9. DOI: 10.1097/01.ju.0000149968.60938.c0. View

17.

Yiou R, Audureau E, Loche C, Dussaud M, Lingombet O, Binhas M . Comprehensive evaluation of embarrassment and pain associated with invasive urodynamics. Neurourol Urodyn. 2013; 34(2):156-60. DOI: 10.1002/nau.22521. View

18.

Walker M, Kallingal G, Musser J, Folen R, Stetz M, Clark J . Treatment efficacy of virtual reality distraction in the reduction of pain and anxiety during cystoscopy. Mil Med. 2014; 179(8):891-6. DOI: 10.7205/MILMED-D-13-00343. View

19.

Zhang Z, Tang L, Wang X, Xu C, Sun Y . Seeing is believing: a randomized controlled study from China of real-time visualization of flexible cystoscopy to improve male patient comfort. J Endourol. 2011; 25(8):1343-6. DOI: 10.1089/end.2011.0084. View

20.

Greenstein A, Bar-Yosef Y, Chen J, Matzkin H . Does information provided to men before a urodynamic study affect their expectation of pain?. BJU Int. 2005; 96(9):1307-9. DOI: 10.1111/j.1464-410X.2005.05828.x. View