Application of modified "Bag Squeeze" method in flexible cystoscopy and analysis of factors influencing pain and anxiety

doi:10.3877/cma.j.issn.1674-3253.2023.03.008

Abstract

Abstract:

Objective

To explore the effects of the modified "Bag Squeeze" technique, and the relative factors of pain and anxiety during flexible cystoscopy.

Methods

A total of 200 male patients underwent flexible cystoscopy between March 2020 and April 2021. Among them, 100 patients received the modified "Bag Squeeze" technique (Group B), while the rest received the non-modified "Bag Squeeze" technique (Group A). All participants completed a pain questionnaire (visual analog scale) and anxious questionnaire (the Amsterdam preoperative anxiety and information scale) after cystoscopy, followed by a repeat pain questionnaire 24 h later. The perioperative outcomes were compared between the two groups.

Results

Patients in Group A and Group B were similar in terms of age, BMI, previous TUR-bt history, BPH, hypertension, diabetes mellitus, and location. The VAS score at the end of examination, 24h after examination and APAIS score at the end of examination in the modified "Bag Squeeze" group were significantly lower than those in the control group, and the differences were statistically significant (P<0.05); benign prostatic hyperplasia had no significant effect on the pain and anxiety after examination, but combined with severe benign prostatic hyperplasia could aggravate the microscopic pain of patients.

Conclusions

The modified "Bag Squeeze" method helps to reduce the pain and anxiety of patients during flexible cystoscopy and ensure the smooth progress of the examination; how to relieve the discomfort of microscopic examination in patients with severe benign prostatic hyperplasia still needs to be further explored.

Key words: Flexible cystoscopy, Bag Squeeze, Pain, Anxiety

Qi Wang, Xin Chen, Jie Min, Lu Fang, Zhiqi Liu, Wei Sun, Dexin Yu. Application of modified "Bag Squeeze" method in flexible cystoscopy and analysis of factors influencing pain and anxiety[J]. Chinese Journal of Endourology(Electronic Edition), 2023, 17(03): 237-241.

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Figures/Tables 7

References 16

[1]	Xie YW, Wang W, Yan W, et al. Efficacy of urination in alleviating man's urethral pain associated with flexible cystoscopy: a single-center randomized trial[J]. BMC Urol, 2020, 20(1): 2.
[2]	Berajoui MB, Aditya I, Herrera-Caceres J, et al. A prospective randomized controlled trial of irrigation "bag squeeze" to manage pain for patients undergoing flexible cystoscopy [J]. J Urol, 2020, 204(5): 1012-1018.
[3]	Celik F, Edipoglu IS. Evaluation of preoperative anxiety and fear of anesthesia using APAIS score [J]. Eur J Med Res, 2018, 23(1): 41.
[4]	Giulianelli R, Gentile BC, Mirabile G, et al. Narrow band imaging reduces persistence of cancer in patients with pT1 high grade bladder cancer[J]. Eur J Surg Oncol, 2019, 45(3): 466-470.
[5]	林祯祥, 蒲小勇, 刘久敏, 等. 联合检测尿液中Survivin和MUC7在膀胱癌诊断中的临床应用[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2019, 13(3): 166-169.
[6]	Giulianelli R, Gentile BC, Albanesi L, et al. Narrow band imaging (NBI) cystoscopy and assisted bipolar TUR-BT: A preliminary experience in a single centre[J]. Arch Ital Urol Androl, 2017, 89(3): 232-235.
[7]	Mumm JN, Eismann L, Rodler S, et al. Listening to music during outpatient cystoscopy reduces pain and anxiety and increases satisfaction: results from a prospective randomized study[J]. Urol Int, 2021, 105(9-10): 792-798.
[8]	Gezginci E, Iyigun E, Kibar Y, et al. Three distraction methods for pain reduction during cystoscopy: a randomized controlled trial evaluating the effects on pain, anxiety, and satisfaction[J]. J Endourol, 2018, 32(11): 1078-1084.
[9]	Hetou K, Halstuch D, Lavi A, et al. A Randomized controlled trial of a modified cystoscopy technique using the peak-end rule in order to improve pain and anxiety[J]. Urology, 2021, 154 (1): 33-39.
[10]	Biardeau X, Lam O, Ba V, et al. Prospective evaluation of anxiety, pain, and embarrassment associated with cystoscopy and urodynamic testing in clinical practice[J]. Can Urol Assoc J, 2017, 11(3-4): 104-110.
[11]	Carrion A, Garcia-Cruz, Fernandez C, et al. Prior lubrication of the urethra does not reduce perception in men undergoing flexible cystoscopy [J]. Urol Int, 2016, 97(4): 392-396.
[12]	Khan J, Kamal MS, D’Arcy FT, et al. Biopsy at flexible cystoscopy: is it worthwhile? Ir J Med Sci, 2021, 190(1): 437-439.
[13]	Olivero A, Riccardi N, Ndrevataj D, et al. Flexible cystoscopy for ureteral stent removal without antimicrobial prophylaxis. A prospective observational study[J]. Urologia, 2021, 88(2): 130-134.
[14]	Ucar M, Oguz F, Gecit I, et al. Comparing 2% lidocaine gel (Dispogel and Cathejell) in cystoscopy[J]. J Int Med Res, 2019, 47(9): 4225-4229.
[15]	Foo KT. What is a disease? What is the disease clinical benign prostatic hyperplasia (BPH) [J]? World J Urol, 2019, 37(7):1293-1296.
[16]	Lokeshwar SD, Harper BT, Webb E, et al. Epidemiology and treatment modalities for the management of benign prostatic hyperplasia[J]. Transl Androl Urol, 2019, 8(5):529-539.

组别	例数	年龄[岁，(±s)]	体质量指数[kg/m²，(±s)]	TURBT史[例(%)]	合并BPH[例(%)]	合并重度BPH[例(%)]	合并糖尿病[例(%)]	合并高血压[例(%)]	平卧分腿体位[例(%)]
改良"Bag Squeeze"组	100	47.7±9.7	23.6±1.0	21（20）	31（31）	17（17）	14（14）	17（17）	30（30）
对照组	100	47.7±10.3	23.6±0.4	16（16）	37（37）	25（25）	13（13）	18（18）	32（32）
统计值		t=0.056	t=-0.277	χ²=0.829	χ²=0.802	χ²=1.929	χ²=0.043	χ²=0.035	χ²=0.094
P值		0.955	0.782	0.363	0.370	0.165	0.836	0.852	0.760

组别	例数	年龄[岁，(±s)]	体质量指数[kg/m²，(±s)]	TURBT史[例(%)]	合并BPH[例(%)]	合并重度BPH[例(%)]	合并糖尿病[例(%)]	合并高血压[例(%)]	平卧分腿体位[例(%)]
改良"Bag Squeeze"组	100	47.7±9.7	23.6±1.0	21（20）	31（31）	17（17）	14（14）	17（17）	30（30）
对照组	100	47.7±10.3	23.6±0.4	16（16）	37（37）	25（25）	13（13）	18（18）	32（32）
统计值		t=0.056	t=-0.277	χ²=0.829	χ²=0.802	χ²=1.929	χ²=0.043	χ²=0.035	χ²=0.094
P值		0.955	0.782	0.363	0.370	0.165	0.836	0.852	0.760

组别	例数	检查时间[min，(±s)]	VAS评分(分)		APAIS评分[分，(±s)]
组别	例数	检查时间[min，(±s)]	检查完成时(±s)	检查后24 h[M(Q)]	检查后24 h
改良"Bag Squeeze"组	100	9.8±1.1	1.1±0.9	0(0，1)	8.6±1.4
对照组	100	10.5±1.5	1.7±0.9	1(0，1)	9.8±1.8
统计值		t=0.002	t=0.936	Z=4.484	t=0.055
P值		<0.001	<0.001	<0.001	<0.001

组别	例数	检查时间[min，(±s)]	VAS评分(分)		APAIS评分[分，(±s)]
组别	例数	检查时间[min，(±s)]	检查完成时(±s)	检查后24 h[M(Q)]	检查后24 h
改良"Bag Squeeze"组	100	9.8±1.1	1.1±0.9	0(0，1)	8.6±1.4
对照组	100	10.5±1.5	1.7±0.9	1(0，1)	9.8±1.8
统计值		t=0.002	t=0.936	Z=4.484	t=0.055
P值		<0.001	<0.001	<0.001	<0.001

组别	例数	检查时间[min，(±s)]	VAS评分(分)		APAIS评分[分，(±s)]
组别	例数	检查时间[min，(±s)]	检查完成时(±s)	检查后24 h[M(Q)]	检查后24 h
非重度BPH组	158	10.1±1.4	1.3±1.0	1(0，1)	9.1±1.7
重度BPH组	42	9.9±1.3	1.7±0.9	1(0，1)	9.4±1.4
统计值		t=0.383	t=0.331	Z=0	t=0.249
P值		0.355	0.027	1	0.310

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