chlorhexidine-gluconate--lidocaine-drug-combination and Pain

What's known on the subject? and What does the study add? Flexible cystoscopy is commonly performed. Several studies show that topical anaesthetic lubricant reduces patient discomfort, particularly with long lubricant retention times (15-25 min). No studies have specifically addressed whether a short, clinically manageable retention time provides any benefit over immediate cystoscopy. Our study demonstrates that delay by a 3-min interval provides no benefit to patients and a more expedient approach can be justified without compromising patient comfort. LAY-TERM SUMMARY: This prospective comparative trial randomizes 50 men to undergo flexible cystoscopy with insertion of local anaesthetic lubricant either immediately prior to cystoscope insertion or after a 3-min interval. Patients then report discomfort on a visual analogue scale. We show that there is no benefit to delay and therefore a more expedient approach can be justified.. • To determine whether a short, clinically manageable time delay between lubrication with topical local anaesthetic and insertion of the flexible cystoscope, vs immediate insertion, reduces discomfort in male patients.. • This was a prospective comparative trial. • Male patients undergoing simple flexible cystoscopy were randomized to undergo cystoscope insertion either immediately after lubrication with topical lignocaine gel or after a 3-min delay. • Patient-reported pain of the procedure was recorded on a visual analogue scale and data were statistically analysed.. • Fifty male patients were randomized to cystoscope insertion either immediately following lubrication or after a 3-min delay. • Mean pain score in the immediate insertion group was 11.94 mm (95% confidence interval [CI] 7.53-16.36) compared with 10.52 mm (95% CI 6.24-14.80) in the 3-min delay group. • The mean difference between the two groups was 1.42 mm (95% CI -4.57 to 7.41, P= 0.64).. • Findings show that patient comfort is similar between the two groups and therefore there is no benefit in delaying insertion by a 3-min interval. • Flexible cystoscopy is a well tolerated outpatient procedure.

Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Anesthetics, Local; Chlorhexidine; Cystoscopy; Drug Combinations; Gels; Hematuria; Humans; Lidocaine; Lubricants; Male; Middle Aged; Pain; Pain Measurement; Prospective Studies; Time Factors; Urinary Bladder Neoplasms

Non-gonococcal urethritis (NGU) is conventionally treated with oral antibiotics. With this Phase II study, we investigated the action of a locally disinfecting substance, Instillagel, in symptomatic NGU. Instillation treatment was performed twice daily to 32 male patients with symptomatic NGU. To evaluate the therapeutic outcome, a smear was taken from the urethra and an urine examination was performed at baseline as well as at 5 and 8 days after the start of the treatment. Pain and micturition symptoms were determined by a questionnaire with analog scales taken before and after therapy. A pre/post comparison of the urethral smears of the patients with symptomatic NGU showed a significant difference (P < 0.0001). The microbial count in the urine did not show a significant difference. The symptoms micturition (P<0.0001) and pain in the urethra (P<0.0001) were significantly improved. This Phase II study confirmed that local antiseptic treatment of NGU can offer an alternative to systemic antibiotic treatment.

Topics: Anti-Infective Agents, Local; Chlorhexidine; Colony Count, Microbial; Drug Combinations; Gonorrhea; Humans; Lidocaine; Male; Pain; Treatment Outcome; Urethra; Urethritis; Urination

Topics: Chlorhexidine; Drug Combinations; Emollients; Humans; Lidocaine; Noise; Pain; Petrolatum; Pilonidal Sinus; Skin Care; Suction

Topics: Administration, Intravesical; Anesthetics, Local; Chlorhexidine; Cystoscopy; Diathermy; Drug Combinations; Humans; Lidocaine; Neoplasm Recurrence, Local; Pain; Urinary Bladder Neoplasms