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Does sodium bicarbonate reduce painful voiding after flexible cystoscopy? A prospective, randomized, double-blind, controlled trial
journal contribution
posted on 2023-05-17, 07:01 authored by Wong, L, Huang, JG, Yong, TL, Iain RobertsonIain Robertson, Brough, SJSStudy Type - Therapy (RCT) Level of Evidence 1b Objective To determine if sodium bicarbonate (Ural®) reduces painful voiding after flexible cystoscopy. Patients and Methods 300 patients over 18 years old undergoing elective flexible cystoscopy were enrolled in a randomized, double-blinded, placebo-controlled trial. Patients with active urinary tract infections, indwelling urinary catheters and/or requiring additional procedures such as biopsy and dilatation were excluded. Painful voiding was quantified using a pain analogue scale from 0 to 10. Pre-existing painful voiding, previous experience with Ural® and flexible cystoscopy were recorded. Flexible cystoscopy was performed to a standard protocol. Patients were randomised after recruitment to receive Ural® or placebo (glucose) powder four times a day for two days after the procedure. Trial outcome was assessed by estimating the change in pain incidence and severity from before to two days after by post-procedural questionnaire. Results Painful voiding was present in 84 of the 300 patients post flexible cystoscopy (45 of 160 patients receiving Ural®; 39 of 140 receiving placebo), but overall mean pain scores were low (1.25; standard deviation 2.4; on a 0-10 scale). Treatment with Ural® compared to placebo was associated with a non-significant reduction in frequency of pain (28.9% vs 31.3%; incidence rate ratio 0.66; 95% CI 0.29-1.46; P = 0.30) and severity of pain (odds ratio 0.72; 95% CI 0.30-1.74; P = 0.47). Conclusions In the replicable context of low post-cystoscopy pain levels, we believe Ural® does not reduce painful voiding after flexible cystoscopy.
History
Publication title
British Journal of Urology InternationalVolume
108Issue
5Pagination
718-721ISSN
1464-4096Department/School
School of Health SciencesPublisher
Blackwell Publishing LtdPlace of publication
9600 Garsington Rd, Oxford, England, Oxon, Ox4 2DgRights statement
The definitive published version is available online at: http://www3.interscience.wiley.com/Repository Status
- Restricted