Diclofenac Suppository to Control Pain During Flexible Cystoscopy

Aga Khan University60 enrolled

Overview

Flexible cystoscopy has diagnostic as well as therapeutic role in many patients presenting in urology clinic with lower urinary tract symptoms (frequency, nocturia etc) and hematuria (blood in urine). Pain associated with cystoscopy varies from patient to patient, majority requires local anesthesia or lubricant solution only. During flexible cystoscopy, lubrication, use of topical anesthesia and duration of cystoscopy are recognized as important factors contributing in severity of pain of which use of intraurethral gel left to individual preference. Various studies are available reporting the pain perception with use of various intraurethral gels. Even the highest level of evidence is unable to resolve the query. With this study the investigators hypothesize that pain perception (recorded in form of pain score) during flexible cystoscopy can be reduced with use of per operative diclofenac(Non Steroidal Anti Inflammatory Drug)suppository in comparison to plain gel alone. With better control of pain the investigators aim to increase patient comfort and compliance which will increase the patient satisfaction rate and early return to work.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Pain Hematuria Lower Urinary Tract Symptoms

Eligibility

Sex: MALEMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * All male patients aged 18 and above * Visiting for evaluation of Haematuria or * Lower urinary tract symptoms (which include poor steam of urine,intermittency, hesitancy, incomplete voiding of urine, increase urgency, increase frequency, nocturia and urge incontinence) * For removal of double J ureteral stent will be included in the study. Exclusion criteria: * Patients with clinical evidence of urethral stricture and/or prostatitis, * Patients in which biopsy will be taken, * those having psychiatric illness, * Asthmatics * Kidney, liver disease * Those allergic to NSAIDs (non-steroidal anti-inflammatory drugs) * Those who refuse to participate, * Having history of chronic analgesia use or * Having language barrier will be excluded.

Outcomes

Primary Outcomes

difference in pain score between two groups

Patient under goes the procedure and with in the operating room the outcome assessor(who will be blinded to randomization) will record the pain score.

Time frame: five minutes after procedure

Secondary Outcomes

Need of additional analgesia after the procedure

Patient will be assessed for pain during the stay in recovery that usually last for an hour. If there will be need of additional analgesia (if patient reports pain score of more than 7 on visual analogue scale)the type of analgesia, dose and frequency will be noticed.

Time frame: with in an hour after procedure