Ces Urol 2026, 30(3):137-141 | DOI: 10.48095/cccu2026023

Procedural pain and anxiety during flexible uretrocystoscopy in men - a comparative study of a group of patients with and without local application of an anesthetic gel to the urethra

Hana Ochtinská¹, Marcel Janda², David Brebera³

¹ Katedra ošetřovatelství, Fakulta zdravotnických studií, Univerzita Pardubice

² Urologie, Pardubická nemocnice, Nemocnice Pardubického kraje a.s.

³ Katedra informatiky a matematiky v dopravě, Dopravní fakulta Jana Pernera, Univerzita Pardubice

⁵³ 2 10 Pardubice hana.ochtinska@upce.cz

Major statement: Flexible urethrocystoscopy is an important tool in urology. To reduce pain, an anesthetic gel is administered before the procedure. However, there are discussions about its necessity in foreign studies. The aim of the article is to present data obtained from Czech men and evaluate their subjective perception of pain and anxiety during the examination.

Summary
Aim: To determine the perception of the intensity of procedural pain and anxiety in men undergoing diagnostic flexible urethrocystoscopy.

Material and methods: The analysis included 135 patients divided into two groups – 70 men who received 2% lidocaine gel applied to the external urethral orifice before flexible urethrocystoscopy and 65 men who did not receive this local anesthetic gel. Respondents rated the subjective level of procedural pain and anxiety at selected stages of the examination using a numerical scale of 0–10.

Result: The analysis showed that patients without the application of a local anesthetic gel perceived lower pain intensity both during the procedure (1.4 without gel vs. 1.97 with gel; P = 0.047) and after its completion (0.8 without gel vs. 1.374 with gel; P = 0.014) compared to the group with local anesthetic gel application. In all monitored variables, patients without local anesthetic gel also had lower levels of anxiety, which gradually decreased in individual phases of the examination (2.2 vs. 1.9; P = 0.360; 1.8 vs. 1.4; P = 0.072; 0.8 vs. 0.5; P = 0.115), but the differences were not statistically significant. It was also found that older patients correlated with lower sensitivity to pain and anxiety (age–pain during examination R = –0.251; age–anxiety during examination R = –0.356). The results also indicate that the patient's psychological state significantly influences their perception of pain, especially during local anesthetic gel application.

Conclusion: Although further research is needed, the results of our study did not demonstrate the benefit of applying a local anesthetic gel in reducing subjectively perceived pain and anxiety during diagnostic flexible urethrocystoscopy.

Keywords: flexible urethrocystoscopy – procedural pain – subjective assessment – anxiety

Received: April 11, 2026; Revised: July 12, 2026; Accepted: September 2, 2026; Published: September 21, 2026