Is bladder tumour fulguration under local anaesthesia more painful than cystoscopy only?. (3rd July 2020)

• Record Type: Journal Article
• Authors: Ströck, Viveka; Holmäng, Sten
• Is Part Of: Scandinavian journal of urology. Volume 54:Number 4(2020)
• Page Start: 277
• Page End: 280
• Publication Date: 2020-07-03
• Subjects: Bladder tumour -- local anaesthesia -- VAS-score; Urology -- Periodicals; 616.6
• DOI: 10.1080/21681805.2020.1776768
• Languages: English
• ISSNs: 2168-1805

Abstract

Abstract: Objectives: To prospectively register self-reported pain levels associated with office cystoscopy with or without bladder tumour biopsy and fulguration. Patients and methods: During a 15-month period, patients examined with cystoscopy under local anaesthesia graded their pain level using the Visual Analogue Scale (VAS). All patients were examined in the lithotomy position and lidocaine gel was used in all. A bladder instillation or a submucosal injection of lidocaine was given mainly in patients treated with extirpation of larger tumours. Results: The pain perception was graded by the patients as none (VAS = 0) or mild (VAS = 1–3) in 86% of the 1, 314 cystoscopies. Fewer patients (65% out of 258) reported VAS 0–3 when cystoscopy with biopsy and fulguration of bladder tumour was performed. More than 97% of all patients stated that they would prefer treatment under local anaesthesia in the case of a future recurrence. Conclusion: The VAS-scores after diagnostic cystoscopy are in accordance with those previously reported, with the absolute majority reporting no or mild pain. Patients treated with extirpation of bladder tumours reported higher levels of pain but still within acceptable limits. This confirms the potential of treating most patients with small-sized bladder tumour recurrences under local anaesthesia.