Pd62-01 Interventions to Reduce Cystoscopy Discomfort: A Multi-Site Quality Improvement Pilot

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety III (PD62)1 May 2024PD62-01 INTERVENTIONS TO REDUCE CYSTOSCOPY DISCOMFORT: A MULTI-SITE QUALITY IMPROVEMENT PILOT Avani P. Desai, Ram Sankar Basak, Yair Lotan, John Sperger, Florian Schroeck, Iftach Chaplain, Hannah Roberson, Perla Lopez, Whitney Jenkins, John L. Gore, Michael R. Kosorok, and Angela Smith Avani P. DesaiAvani P. Desai , Ram Sankar BasakRam Sankar Basak , Yair LotanYair Lotan , John SpergerJohn Sperger , Florian SchroeckFlorian Schroeck , Iftach ChaplainIftach Chaplain , Hannah RobersonHannah Roberson , Perla LopezPerla Lopez , Whitney JenkinsWhitney Jenkins , John L. GoreJohn L. Gore , Michael R. KosorokMichael R. Kosorok , and Angela SmithAngela Smith View All Author Informationhttps://doi.org/10.1097/01.JU.0001008656.89655.67.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Each year, over a million individuals undergo office cystoscopy to evaluate the lower urinary tract. About one-third of patients experience major discomfort during this procedure, and over 40% of bladder cancer patients experience substantial anxiety associated with it. A quality improvement pilot explored interventions to decrease pain and anxiety among cystoscopy patients. Our objectives were to assess intervention efficacy and implementation challenges to inform design of a future comparative effectiveness trial. METHODS: Office cystoscopy was performed on 190 adults (University of North Carolina (n=110), University of Texas Southwestern (n=80)). Patients were offered 20mL intraurethral 2% lidocaine with a dwell time of ≤10 or >10 minutes and either listening to music on headphones or real-time visualization of cystoscopy. If a patient declined the offered intervention, their requested intervention was provided and noted. After the procedure, patients recorded cystoscopy pain on the Visual Analog Scale (VAS; range 0-10), pain intensity, and emotional distress-anxiety. We performed a linear regression analysis that controlled for age and number of prior cystoscopies and accounted for correlation among patients nested within institutions. Pain intensity and anxiety were log-transformed. RESULTS: Visualization was significantly associated with decreased VAS, pain intensity, and anxiety (Table 1). Conversely, music was significantly associated with increased anxiety. Increased lidocaine dwell time was not associated with any change in pain or anxiety. 35% of patients declined their offered inventions, 88% of whom were offered music and requested visualization instead of or in addition to music (Figure 1). Most declining patients presented for bladder cancer surveillance (87%) or had undergone prior cystoscopy (84%). CONCLUSIONS: Allowing patients to visualize their cystoscopy in real time during the procedure is an accessible, efficacious, and desired means of significantly reducing pain and anxiety related to cystoscopy. Download PPT Source of Funding: Carolina Medical Student Research Program (University of North Carolina Medical Alumni Fund) © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1285 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Avani P. Desai More articles by this author Ram Sankar Basak More articles by this author Yair Lotan More articles by this author John Sperger More articles by this author Florian Schroeck More articles by this author Iftach Chaplain More articles by this author Hannah Roberson More articles by this author Perla Lopez More articles by this author Whitney Jenkins More articles by this author John L. Gore More articles by this author Michael R. Kosorok More articles by this author Angela Smith More articles by this author Expand All Advertisement PDF downloadLoading ...