A randomised controlled trial to assess pain with urethral swabs
BackgroundUrethral swabs are uncomfortable due to the nature of the mucosa and may be a reason for non-attendance of men at sexually transmitted infection (STI) clinics. This randomised controlled trial describes the extent of discomfort associated with direct urethral sampling, and determines wheth...
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| Veröffentlicht in: | Sexually transmitted infections 2011-03, Vol.87 (2), p.110-113 |
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| creator | Apoola, Ade Herrero-Diaz, Maite FitzHugh, Elley Rajakumar, Raj Fakis, Apostolos Oakden, Jayne |
| description | BackgroundUrethral swabs are uncomfortable due to the nature of the mucosa and may be a reason for non-attendance of men at sexually transmitted infection (STI) clinics. This randomised controlled trial describes the extent of discomfort associated with direct urethral sampling, and determines whether this varies by the type of swab used.MethodsMale patients over the age of 16 years having swab tests were invited to participate and were randomly assigned to receive either a gonorrhoea dacron-tipped swab, a chlamydia rayon-tipped swab or a plastic 10 μl urethral loop first for urethral sampling followed by the others sequentially. Discomfort was measured using a 0–100 mm visual analogue scale (VAS).Findings129 men having urethral swabs carried out as part of their screening tests for STI were invited to participate in the study and 121 were recruited. The median pain scores (IQR) regardless of sampling method, before and after the urethral sampling were, first 0 mm (0–0) and 50 mm (22–71) (p |
| doi_str_mv | 10.1136/sti.2010.042861 |
| format | Article |
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This randomised controlled trial describes the extent of discomfort associated with direct urethral sampling, and determines whether this varies by the type of swab used.MethodsMale patients over the age of 16 years having swab tests were invited to participate and were randomly assigned to receive either a gonorrhoea dacron-tipped swab, a chlamydia rayon-tipped swab or a plastic 10 μl urethral loop first for urethral sampling followed by the others sequentially. Discomfort was measured using a 0–100 mm visual analogue scale (VAS).Findings129 men having urethral swabs carried out as part of their screening tests for STI were invited to participate in the study and 121 were recruited. The median pain scores (IQR) regardless of sampling method, before and after the urethral sampling were, first 0 mm (0–0) and 50 mm (22–71) (p<0.001), second 9 mm (0–28) and 59.5 mm (38.3–78) (p<0.001) and third 10 mm (0–31) and 58 mm (29.3–80) (p<0.001). Direct urethral sampling was associated with a median pain score of 60.5 mm using a rayon swab, 52 mm using a dacron swab and 25.5 mm using a plastic loop.InterpretationDirect urethral sampling is associated with discomfort and/or pain in men, which was significantly greater with a swab than a plastic loop. Urine should therefore be the specimen type of choice. When direct urethral sampling is indicated a loop is preferable to a urethral swab.International Standard Randomised Controlled Trial Number Register numberISRCTN50938901.</description><identifier>ISSN: 1368-4973</identifier><identifier>EISSN: 1472-3263</identifier><identifier>DOI: 10.1136/sti.2010.042861</identifier><identifier>PMID: 21131307</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd</publisher><subject>Adult ; Anesthetics, Local ; Biological and medical sciences ; Chlamydia Infections - diagnosis ; Chlamydia trachomatis ; Cross-Over Studies ; Cystoscopy - adverse effects ; Diagnostic Techniques, Urological - adverse effects ; Diagnostic Techniques, Urological - instrumentation ; Epidemiology. Vaccinations ; General aspects ; genital specimens ; Gonorrhea ; Gonorrhea - diagnosis ; Human infectious diseases. Experimental studies and models ; Humans ; Infectious diseases ; Investigations ; Lidocaine ; Male ; Medical sciences ; men ; Mens health ; Methods ; Neisseria gonorrhoeae ; Pain ; Pain - etiology ; Pain Measurement ; randomised controlled crossover trial ; sexually transmitted infections ; Specimen Handling - adverse effects ; Specimen Handling - instrumentation ; trials ; Urethra - microbiology ; urethral swab ; Urine ; Young Adult</subject><ispartof>Sexually transmitted infections, 2011-03, Vol.87 (2), p.110-113</ispartof><rights>2010, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright: 2010 (c) 2010, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b468t-e339b7db4018a958b338c3a9396fd8257dfe1fef83a270bab11cab807a6d6ca23</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://sti.bmj.com/content/87/2/110.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://sti.bmj.com/content/87/2/110.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,3196,23571,27924,27925,77600,77631</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23900735$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21131307$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Apoola, Ade</creatorcontrib><creatorcontrib>Herrero-Diaz, Maite</creatorcontrib><creatorcontrib>FitzHugh, Elley</creatorcontrib><creatorcontrib>Rajakumar, Raj</creatorcontrib><creatorcontrib>Fakis, Apostolos</creatorcontrib><creatorcontrib>Oakden, Jayne</creatorcontrib><title>A randomised controlled trial to assess pain with urethral swabs</title><title>Sexually transmitted infections</title><addtitle>Sex Transm Infect</addtitle><description>BackgroundUrethral swabs are uncomfortable due to the nature of the mucosa and may be a reason for non-attendance of men at sexually transmitted infection (STI) clinics. This randomised controlled trial describes the extent of discomfort associated with direct urethral sampling, and determines whether this varies by the type of swab used.MethodsMale patients over the age of 16 years having swab tests were invited to participate and were randomly assigned to receive either a gonorrhoea dacron-tipped swab, a chlamydia rayon-tipped swab or a plastic 10 μl urethral loop first for urethral sampling followed by the others sequentially. Discomfort was measured using a 0–100 mm visual analogue scale (VAS).Findings129 men having urethral swabs carried out as part of their screening tests for STI were invited to participate in the study and 121 were recruited. The median pain scores (IQR) regardless of sampling method, before and after the urethral sampling were, first 0 mm (0–0) and 50 mm (22–71) (p<0.001), second 9 mm (0–28) and 59.5 mm (38.3–78) (p<0.001) and third 10 mm (0–31) and 58 mm (29.3–80) (p<0.001). Direct urethral sampling was associated with a median pain score of 60.5 mm using a rayon swab, 52 mm using a dacron swab and 25.5 mm using a plastic loop.InterpretationDirect urethral sampling is associated with discomfort and/or pain in men, which was significantly greater with a swab than a plastic loop. Urine should therefore be the specimen type of choice. When direct urethral sampling is indicated a loop is preferable to a urethral swab.International Standard Randomised Controlled Trial Number Register numberISRCTN50938901.</description><subject>Adult</subject><subject>Anesthetics, Local</subject><subject>Biological and medical sciences</subject><subject>Chlamydia Infections - diagnosis</subject><subject>Chlamydia trachomatis</subject><subject>Cross-Over Studies</subject><subject>Cystoscopy - adverse effects</subject><subject>Diagnostic Techniques, Urological - adverse effects</subject><subject>Diagnostic Techniques, Urological - instrumentation</subject><subject>Epidemiology. Vaccinations</subject><subject>General aspects</subject><subject>genital specimens</subject><subject>Gonorrhea</subject><subject>Gonorrhea - diagnosis</subject><subject>Human infectious diseases. Experimental studies and models</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Investigations</subject><subject>Lidocaine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>men</subject><subject>Mens health</subject><subject>Methods</subject><subject>Neisseria gonorrhoeae</subject><subject>Pain</subject><subject>Pain - etiology</subject><subject>Pain Measurement</subject><subject>randomised controlled crossover trial</subject><subject>sexually transmitted infections</subject><subject>Specimen Handling - adverse effects</subject><subject>Specimen Handling - instrumentation</subject><subject>trials</subject><subject>Urethra - microbiology</subject><subject>urethral swab</subject><subject>Urine</subject><subject>Young Adult</subject><issn>1368-4973</issn><issn>1472-3263</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkN9r1TAUx4Mobk6ffZOCiCB0S3La_HhzXNwUxpyg4ls4aVPWa297zUnZ_O-XS-8m-LKnnHA-58uXD2OvBT8WAtQJpf5Y8vzjlTRKPGGHotKyBKngaZ5BmbKyGg7YC6I151zp2j5nBzIfC-D6kH08LSKO7bTpKbRFM40pTsOQxxR7HIo0FUgUiIot9mNx06frYo4hXce8pBv09JI963Cg8Gr_HrEfZ5--rz6XF1_Pv6xOL0pfKZPKAGC9bn3FhUFbGw9gGkALVnWtkbVuuyC60BlAqblHL0SD3nCNqlUNSjhi75fcbZz-zIGSy5WbMAw4hmkmZ2qolAJpM_n2P3I9zXHM5ZzQRiht63qXd7JQTZyIYujcNvYbjH-d4G7n1mW3bufWLW7zxZt97uw3oX3g72Vm4N0eQGpw6LLYpqd_HFieqTpz5cL1lMLtwx7jb6c06Npd_ly5s19Xlfh2JRzP_IeF95v1oy3vAIE0nOg</recordid><startdate>20110301</startdate><enddate>20110301</enddate><creator>Apoola, Ade</creator><creator>Herrero-Diaz, Maite</creator><creator>FitzHugh, Elley</creator><creator>Rajakumar, Raj</creator><creator>Fakis, Apostolos</creator><creator>Oakden, Jayne</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20110301</creationdate><title>A randomised controlled trial to assess pain with urethral swabs</title><author>Apoola, Ade ; Herrero-Diaz, Maite ; FitzHugh, Elley ; Rajakumar, Raj ; Fakis, Apostolos ; Oakden, Jayne</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b468t-e339b7db4018a958b338c3a9396fd8257dfe1fef83a270bab11cab807a6d6ca23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Anesthetics, Local</topic><topic>Biological and medical sciences</topic><topic>Chlamydia Infections - diagnosis</topic><topic>Chlamydia trachomatis</topic><topic>Cross-Over Studies</topic><topic>Cystoscopy - adverse effects</topic><topic>Diagnostic Techniques, Urological - adverse effects</topic><topic>Diagnostic Techniques, Urological - instrumentation</topic><topic>Epidemiology. Vaccinations</topic><topic>General aspects</topic><topic>genital specimens</topic><topic>Gonorrhea</topic><topic>Gonorrhea - diagnosis</topic><topic>Human infectious diseases. Experimental studies and models</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Investigations</topic><topic>Lidocaine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>men</topic><topic>Mens health</topic><topic>Methods</topic><topic>Neisseria gonorrhoeae</topic><topic>Pain</topic><topic>Pain - etiology</topic><topic>Pain Measurement</topic><topic>randomised controlled crossover trial</topic><topic>sexually transmitted infections</topic><topic>Specimen Handling - adverse effects</topic><topic>Specimen Handling - instrumentation</topic><topic>trials</topic><topic>Urethra - microbiology</topic><topic>urethral swab</topic><topic>Urine</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Apoola, Ade</creatorcontrib><creatorcontrib>Herrero-Diaz, Maite</creatorcontrib><creatorcontrib>FitzHugh, Elley</creatorcontrib><creatorcontrib>Rajakumar, Raj</creatorcontrib><creatorcontrib>Fakis, Apostolos</creatorcontrib><creatorcontrib>Oakden, Jayne</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Sexually transmitted infections</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Apoola, Ade</au><au>Herrero-Diaz, Maite</au><au>FitzHugh, Elley</au><au>Rajakumar, Raj</au><au>Fakis, Apostolos</au><au>Oakden, Jayne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A randomised controlled trial to assess pain with urethral swabs</atitle><jtitle>Sexually transmitted infections</jtitle><addtitle>Sex Transm Infect</addtitle><date>2011-03-01</date><risdate>2011</risdate><volume>87</volume><issue>2</issue><spage>110</spage><epage>113</epage><pages>110-113</pages><issn>1368-4973</issn><eissn>1472-3263</eissn><abstract>BackgroundUrethral swabs are uncomfortable due to the nature of the mucosa and may be a reason for non-attendance of men at sexually transmitted infection (STI) clinics. This randomised controlled trial describes the extent of discomfort associated with direct urethral sampling, and determines whether this varies by the type of swab used.MethodsMale patients over the age of 16 years having swab tests were invited to participate and were randomly assigned to receive either a gonorrhoea dacron-tipped swab, a chlamydia rayon-tipped swab or a plastic 10 μl urethral loop first for urethral sampling followed by the others sequentially. Discomfort was measured using a 0–100 mm visual analogue scale (VAS).Findings129 men having urethral swabs carried out as part of their screening tests for STI were invited to participate in the study and 121 were recruited. The median pain scores (IQR) regardless of sampling method, before and after the urethral sampling were, first 0 mm (0–0) and 50 mm (22–71) (p<0.001), second 9 mm (0–28) and 59.5 mm (38.3–78) (p<0.001) and third 10 mm (0–31) and 58 mm (29.3–80) (p<0.001). Direct urethral sampling was associated with a median pain score of 60.5 mm using a rayon swab, 52 mm using a dacron swab and 25.5 mm using a plastic loop.InterpretationDirect urethral sampling is associated with discomfort and/or pain in men, which was significantly greater with a swab than a plastic loop. Urine should therefore be the specimen type of choice. When direct urethral sampling is indicated a loop is preferable to a urethral swab.International Standard Randomised Controlled Trial Number Register numberISRCTN50938901.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd</pub><pmid>21131307</pmid><doi>10.1136/sti.2010.042861</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Anesthetics, Local Biological and medical sciences Chlamydia Infections - diagnosis Chlamydia trachomatis Cross-Over Studies Cystoscopy - adverse effects Diagnostic Techniques, Urological - adverse effects Diagnostic Techniques, Urological - instrumentation Epidemiology. Vaccinations General aspects genital specimens Gonorrhea Gonorrhea - diagnosis Human infectious diseases. Experimental studies and models Humans Infectious diseases Investigations Lidocaine Male Medical sciences men Mens health Methods Neisseria gonorrhoeae Pain Pain - etiology Pain Measurement randomised controlled crossover trial sexually transmitted infections Specimen Handling - adverse effects Specimen Handling - instrumentation trials Urethra - microbiology urethral swab Urine Young Adult |
| title | A randomised controlled trial to assess pain with urethral swabs |
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