Effect of intraurethral dwell time of local anesthetic jelly on pain perception in men undergoing outpatient rigid cystoscopy: a randomized prospective study

To determine optimum duration of intraurethral 2% lidocaine jelly for pain relief during outpatient rigid cystoscopy. This prospective randomized study was conducted between June 2012 and November 2013. Four hundred consecutive adult males requiring diagnostic rigid cystoscopy were randomized into four groups depending on intraurethral 2% lidocaine jelly dwell time before rigid cystoscopy: jelly was instilled 5, 10, 15, and 20 minutes before start of the procedure in group A, B, C, and D patients, respectively. The patients' age, patient-reported preoperative anxiety score, patient-reported intraoperative pain score, the surgeon-reported patient's pain score, and the duration of rigid cystoscopy were recorded and analyzed. The mean age, patient-reported preoperative anxiety score, and duration of rigid cystoscopy were similar between the four groups with no significant difference noted between them. The least and highest mean patient-reported and surgeon-reported intraoperative pain scores were reported in group C (1.49±0.82 and 1.58±0.67) patients and group A (4.86±1.24 and 4.04±1.11) patients, respectively, while no significant difference was found in these scores between group C and D patients. For male patients undergoing diagnostic rigid cystoscopy, an intraurethral dwell time of 15 minutes (of 20 mL 2% lidocaine jelly) provided optimum pain relief.