Better Comfort for Both Patient and Doctor: Prospective Randomized Study about Flexible and Rigid Cystoscopy

Abstract

Objective Cystoscopy is the gold standard method for the diagnosis and follow-up of non-muscle invasive bladder cancer (NMIBC). Since cystoscopy was performed under local anesthesia in office condition, patients’ discomfort and pain during the procedure gained importance. Consequently, flexible cystoscopy (FC) has been used since 1970s to improve the patient comfort. In this study, we compared both flexible and rigid cystoscope in terms of patients and doctors comfort. Besides, we evaluated the effect of the type of cystoscopy for patients with benign prostatic hyperplasia (BPH). Materials and Methods We evaluated male patients with NMIBC. We excluded patients with urethral stricture, active hematuria and those who underwent diagnostic cystoscopy or first local cystoscopy for the first time. The patients were sequentially randomized to flexible (group 1) or rigid cystoscopy (group 2) groups. Pain, hematuria, disuria, and the postoperative necessity for medication were noted. In addition, doctor comfort during procedure was scored. Results When we compared both groups after the cystoscopy, patient and physician comfort in group 1 was statistically significantly superior to that in group 2 (p<0.001). Besides, flexible cystoscopy provided better results in terms of postoperative hematuria, pain, and need of medication of patients. When we included only patients with BPH, group 1 also provided better results. Conclusion Although flexible cystoscopy is costly, its higher comfort, and lesser postoperative morbidity may make it cost-effective, cumulatively. On the other hand, FC may also be favorable for older patients with BPH.

Keywords

• Bladder cancer
• cystoscopy
• rigid
• flexible
• doctor comfort