POUR-UP: Power of Urination in Relieving Urethral Pain During Flexible Cystoscopy in Males

ABSTRACTThis study aimed to investigate the effectiveness of micturition (urination) during flexible cystoscopy in alleviating urethral pain in males. A single-blinded, randomized controlled trial was conducted with 103 male outpatients at a tertiary care hospital in Malaysia. Participants, aged 18–80, undergoing flexible cystoscopy were randomly assigned to either a control or interventional group. The interventional group was instructed to urinate during the procedure, while the control group received no such instructions. All patients received standard lidocaine gel before the examination. Patient discomfort was assessed using Visual Analogue Scores (VAS) at three points: before gel instillation (baseline), immediately after the procedure, and 15 minutes post-examination. Age, BMI, duration of the examination, and examiner experience were also recorded to explore their correlation with the immediate post-procedure pain score. The interventional group reported significantly lower pain scores immediately after the procedure (p < 0.001) and 15 minutes later (p < 0.005) compared to the control group. However, there was no statistically significant difference in age, BMI, examination duration, or examiner experience level between the two groups regarding the pain score immediately post-procedure. These findings suggest that urination during flexible cystoscopy can substantially alleviate urinary discomfort and lead to a significant reduction in urethral pain in males. This approach mayprovide a valuable method to improve patient comfort during the procedure.