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Voiding during catheter insertion attenuates pain in males

13 Apr 2017

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]

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Most Read Articles
Elvira Manzano, 4 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.
Tristan Manalac, Yesterday
Statin use, particularly in smokers, obese patients and nondiabetics, has a strong and dose-dependent association with decreasing risk of pancreatic ductal adenocarcinoma (PDAC), according to a new study.