Voiding during catheter insertion attenuates pain in males
Voiding during insertion of the catheter into the urethra may effectively reduce the pain associated with male urethral catheterization, a study suggests.
The prospective study randomly assigned 96 men (median age 66 years) who were referred for multichannel urodynamic study to two groups, according to the catheter insertion technique. Patients in the first group were instructed to void during catheterization, while those in the second group received no guidance prior to or during the procedure.
None of the patients reported use of analgesics within the previous 24 hours, active urinary tract infection, having an indwelling urethral catheter, pre-existing urethral pain, and known urethral stricture or inability to cooperate with pain assessment due to mental disorders.
Using a 0 to 10 visual analogue scale (VAS), pain was evaluated at the following time points: prior and immediately after instillation of the lubricant gel into the urethra, immediately after the insertion of the catheter, and 15 minutes after the test.
Patient characteristics, including demographic, clinical and urodynamic parameters, were similar across the study groups. The median VAS pain score was notably different between groups 1 and 2, but only during catheterization (2; interquartile range, 1 to 3 vs 4; interquartile range, 3 to 5; p<0.001). The reported scores at the other time points were similar between the two groups.
Urethral catheterization is the procedure that involves placement of catheters to drain the bladder. It is performed to drain the bladder during and after surgical procedures requiring anaesthetics, to assess urinary output in critically ill-patients, to collect reliable urine specimens, for urodynamics evaluation, for radiographic studies (eg, cystograms), to assess residual urine, and for obtaining samples for urinalysis in infants. [East Cent Afr J Surg 2009;14:18–24]
While common, urethral catheterization is not without complications. Catheter-associated urinary tract infection is the most common nosocomial infection, accounting for up to 40 percent of all nosocomial infection in US hospitals each year. Prevention of these infections and other complications of catheterization starts with restricting catheterization to those patients for whom it is appropriate. [East Cent Afr J Surg 2009;14:18–24; N Engl J Med 2006;354:21–24]