A Randomized Control Trial Comparing Combined Glandular Lidocaine Injection and Intraurethral Lidocaine Gel with Intraurethral Lidocaine Gel Alone in Cystoscopy and Urethral Dilatation

Cystoscopy is one of the most common urologic procedures. The aim of this study is to investigate the combined effect of intraurethral lidocaine gel and intraglandular injection of lidocaine 2% on pain during and after cystoscopy.
In this double-blind, parallel group randomized clinical trial, 156 patients referred for double J removal, urethral dilatation, or cystoscopy were enrolled. The patients were divided into two groups, A and B. All patients received 20 cc of intraurethral lidocaine gel 2%. In group A (N = 75), lidocaine 2% was also injected into the glans penis. The patients in group B (N = 81) only received the intraurethral lidocaine gel. Cystoscopy was performed 10 minutes later. The primary outcome of interest was measured in terms of pain score (visual analogue scale) during and 5 minutes after cystoscopy.
Immediate pain score after the procedure was 3.4 ± 3 and 4.6 ± 3 in groups A and B, respectively (P = .011).
Based on the findings of the present study, lidocaine injection into the glans penis significantly reduced pain perception.