| Summary: | Objective
Cystoscopy is the gold standard method for the diagnosis and follow-up
of non-muscle invasive bladder cancer (NMIBC). Since cystoscopy was
performed under local anesthesia in office condition, patients’ discomfort
and pain during the procedure gained importance. Consequently, flexible
cystoscopy (FC) has been used since 1970s to improve the patient comfort.
In this study, we compared both flexible and rigid cystoscope in terms of
patients and doctors comfort. Besides, we evaluated the effect of the type
of cystoscopy for patients with benign prostatic hyperplasia (BPH).
Materials and Methods
We evaluated male patients with NMIBC. We excluded patients with urethral
stricture, active hematuria and those who underwent diagnostic cystoscopy
or first local cystoscopy for the first time. The patients were sequentially
randomized to flexible (group 1) or rigid cystoscopy (group 2) groups. Pain,
hematuria, disuria, and the postoperative necessity for medication were
noted. In addition, doctor comfort during procedure was scored.
Results
When we compared both groups after the cystoscopy, patient and
physician comfort in group 1 was statistically significantly superior to
that in group 2 (p<0.001). Besides, flexible cystoscopy provided better
results in terms of postoperative hematuria, pain, and need of medication
of patients. When we included only patients with BPH, group 1 also
provided better results.
Conclusion
Although flexible cystoscopy is costly, its higher comfort, and lesser
postoperative morbidity may make it cost-effective, cumulatively. On the
other hand, FC may also be favorable for older patients with BPH.
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