Comparison of the Use of Prilocaine and Lidocaine Gel During the Cystoscopy

Abstract

Aim: In this study, the difference of the activity between the prilocaine and lidocaine gel instillation into the urethra was investigated in order to reduce the patient's pain and to increase the comfort of the procedure during the cystoscopy which was commonly used in the practice of urology. Material and Method: 134 patients who were decided to be performed the cystoscopy for various reasons between the years of 2008 and 2011 were randomly divided into two groups2% of lidocaine gel to the first group and 20 cc of 2% of prilocaine to the second group were given from the urethral route 5 minutes before the cystoscopy. Visual Analog Scale (VAS) was used in the assessment of the pain levels of the patients during the cystoscopy. The discomforts of the patients during the process were assessed with the question like "would you have the process done again if necessary". In patients in both groups, the levels of the pain and the hemodynamic changes were recorded at the beginning of the procedure, during the procedure and after the procedure. Results: There was no significant difference in terms of the hemodynamic changes between the two groups. If it is necessary to repeat the cystoscopy, while the average score of VAS for prilocaine was 3.8 and the rate of the performance was 80%, these values for lidocaine were about 5 and 70% respectively. Cystoscopy was viewed as more comfortable both for the doctor and for the patient in the group used prilocaine. It was understood that the majority of the patients would be able to perform the cystoscopy again if necessary. Discussion: Reducing the sense of the pain in the urethra, urethral instillation of the prilocaine has provided less pain during the rigid cystoscopy especially for the outpatients and has prevented the formation of the bad memories about the process. Prilocaine has drawn its score of VAS down 1.2 points compared to lidocaine and has increased the rate of doing cystoscopy again of patient by 10% when required.