From the Guidelines
Pain is common after a cystoscopy, but it is typically mild and can be managed with non-opioid pain management options. According to a recent expert panel consensus published in The Journal of Urology in 2020 1, the recommended minimum number of opioid tablets for diagnostic cystoscopy is 0 tablets, suggesting that opioids are not typically expected or recommended for this procedure. The panel recommended that specific instructions on pain management should be provided to patients, including the dose, frequency, and duration of non-opioid agents, such as acetaminophen 1,000 mg every 6 hours and ibuprofen 800 mg every 8 hours in staggered fashion.
Some common symptoms that patients may experience after a cystoscopy include:
- A burning sensation during urination
- Slight blood in the urine
- Increased urinary frequency These symptoms occur because the procedure involves inserting a thin tube with a camera through the urethra into the bladder, which can cause temporary irritation to the urinary tract lining. To manage post-procedure discomfort, patients can take over-the-counter pain relievers like acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil, Motrin) 400-600mg every 6-8 hours as needed, as recommended by the expert panel 1. Drinking plenty of water (8-10 glasses daily) helps flush the bladder and reduces irritation. A warm bath may also provide relief.
Patients should contact their doctor if they experience severe pain, heavy bleeding, fever above 101°F, inability to urinate, or if symptoms worsen or persist beyond 48 hours, as these could indicate complications requiring medical attention. The expert panel's recommendations prioritize patient expected needs and preferences for analgesia, and emphasize the importance of providing specific instructions on pain management to patients 1.
From the Research
Pain after Cystoscopy
- Pain is a common issue for patients undergoing cystoscopy, with some describing it as high or even "unbearable" 2
- The procedure can cause discomfort, anxiety, and dissatisfaction in patients, highlighting the need for effective pain reduction methods 3, 4
Prevalence of Pain
- Studies have shown that pain severity during cystoscopy can be significant, with patients reporting high levels of discomfort 2, 4
- The use of distraction methods, such as video, music, or stress balls, can help reduce pain and anxiety during the procedure 4
- Intraurethral lidocaine has been shown to provide statistically significant pain reduction in men undergoing flexible cystoscopy 5
Reducing Pain and Discomfort
- Heating therapy has been found to be a convenient and effective nursing intervention that decreases pain and anxiety and enhances patient satisfaction during cystoscopy 3
- The use of intraurethral lidocaine, particularly with a longer dwell time, can provide significant pain reduction in men undergoing flexible cystoscopy 5
- Distraction methods, such as video, can be an effective way to reduce pain, anxiety, and dissatisfaction during rigid cystoscopy 4