Better Comfort for Both Patient and Doctor: Prospective Randomized Study about Flexible and Rigid Cystoscopy

Objective\udCystoscopy is the gold standard method for the diagnosis and follow-up\udof non-muscle invasive bladder cancer (NMIBC). Since cystoscopy was\udperformed under local anesthesia in office condition, patients’ discomfort\udand pain during the procedure gained importance. Consequently, flexible\udcystoscopy (FC) has been used since 1970s to improve the patient comfort.\udIn this study, we compared both flexible and rigid cystoscope in terms of\udpatients and doctors comfort. Besides, we evaluated the effect of the type\udof cystoscopy for patients with benign prostatic hyperplasia (BPH).\udMaterials and Methods\udWe evaluated male patients with NMIBC. We excluded patients with urethral\udstricture, active hematuria and those who underwent diagnostic cystoscopy\udor first local cystoscopy for the first time. The patients were sequentially\udrandomized to flexible (group 1) or rigid cystoscopy (group 2) groups. Pain,\udhematuria, disuria, and the postoperative necessity for medication were\udnoted. In addition, doctor comfort during procedure was scored.\udResults\udWhen we compared both groups after the cystoscopy, patient and\udphysician comfort in group 1 was statistically significantly superior to\udthat in group 2 (p<0.001). Besides, flexible cystoscopy provided better\udresults in terms of postoperative hematuria, pain, and need of medication\udof patients. When we included only patients with BPH, group 1 also\udprovided better results.\udConclusion\udAlthough flexible cystoscopy is costly, its higher comfort, and lesser\udpostoperative morbidity may make it cost-effective, cumulatively. On the\udother hand, FC may also be favorable for older patients with BPH. \u