From the Research
Urethral dilatation can be a painful procedure, but the level of discomfort varies among patients, and most healthcare providers use local anesthesia to numb the urethra before the procedure, which significantly reduces pain. The pain experienced during urethral dilatation is due to the stretching of sensitive nerve endings in the urethra. Some patients may experience mild to moderate discomfort during the procedure, described as pressure or a burning sensation. After the procedure, patients might feel soreness or have a mild burning sensation when urinating for 24-48 hours.
Factors Influencing Pain
- The use of local anesthesia, such as lidocaine gel, can significantly reduce pain during the procedure, as shown in a study comparing 2% lidocaine gel with plain lubricating gel for minimizing pain in men undergoing flexible cystoscopy 1.
- The technique used during the procedure can also impact the level of pain experienced, with studies suggesting that instructing patients to void during catheterization can reduce pain levels 2.
- The type of anesthesia used can also influence pain levels, with general anesthesia potentially causing more pain than regional anesthesia, but also facilitating earlier dilatation of ureters and access to the stone 3.
Pain Management
- Pain management typically includes over-the-counter pain relievers like acetaminophen or ibuprofen (400-600mg every 6-8 hours as needed).
- The procedure itself is relatively quick, usually taking only a few minutes.
- Most patients find the procedure tolerable, especially when weighed against the relief from urinary symptoms that often follows successful dilation.
Recent Evidence
- A recent study published in 2021 compared the effects of general, spinal, and epidural anesthesia on ureter access and surgical outcomes during flexible ureterorenoscopy, finding that general anesthesia facilitated earlier dilatation of ureters and access to the stone, but caused more pain and nausea 3.
- Another study published in 2017 found that pain levels during urethral catheterization can be significantly reduced when patients are instructed to void during the insertion of the catheter 2.