scholarly journals Randomised Controlled Study to Evaluate the Outcomes between Rigid and Flexible Cystoscopy in Men with Lower Urinary Tract Symptoms Undergoing Diagnostic Cystoscopy

2021 ◽  
Vol 10 (12) ◽  
pp. 888-893
Author(s):  
Gaurish Sawant ◽  
Pawan Lal ◽  
Jagdeep Yadav ◽  
Lovenish Kumar ◽  
Rahul Saini ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Controlled Study ◽  
Flexible Cystoscopy ◽  
Post Procedure ◽  
Urinary Tract Symptoms ◽  
Flexible Cystoscope ◽  
The Mean ◽  
Lower Urinary

BACKGROUND Cystoscopy is a commonly performed routine outpatient procedure and an essential diagnostic tool in urology. It may be performed using either rigid or flexible cystoscopes. From the clinical perspective, it might appear that flexible cystoscopy causes less discomfort than rigid cystoscopy, but remarkably head-to- head comparisons of these two devices are sparse. We wanted to compare rigid cystoscopy with flexible cystoscopy in men with lower urinary tract symptoms (LUTS), in terms of the post-procedure outcomes defined as discomfort / pain experienced by the patient using the visual analogue score (VAS) scoring and duration of the procedure. METHODS A total of 60 male patients with LUTS were randomised to flexible and rigid cystoscopy groups (N = 30 each group). Cystoscopy was done using appropriate rigid and flexible cystoscope. Post procedure, patient was assessed with VAS scaling for pain. The duration of the procedure and any post-procedure discomfort and complication were also noted. RESULTS The mean age of patients of flexible cystoscopy group was comparable to that of a rigid cystoscopy group (39.43 ± 11.45 vs. 41.7 ± 10.8, P = 0.433). The mean duration (minutes) for flexible cystoscopy was significantly less than that of rigid cystoscopy (8.53 ± 1.81 vs. 9.77 ± 2.14, P = 0.019). The mean VAS score for flexible cystoscopy was significantly less than that of rigid cystoscopy (2.57 ± 0.97 vs. 3.97 ± 1.1, P < 0.0001). There was no significant difference between groups in terms of diagnosis (P = 0.796). Post-procedure complications were also comparable between the two groups. CONCLUSIONS Flexible cystoscopy caused less pain and discomfort as compared to rigid cystoscopy. Duration of procedure was also less for the flexible cystoscope. KEY WORDS Cystoscopy, Flexible Cystoscopy, Lower Urinary Tract Symptoms, Pain, Rigid Cystoscopy

scholarly journals Prospective randomized controlled study directly comparing tadalafil and tamsulosin for male patients with lower urinary tract symptoms

2018 ◽  
Author(s):  
Takumi Takeuchi ◽  
Satoshi Toyokawa ◽  
Yumiko Okuno ◽  
Noriko Ishida ◽  
Masanari Yamagoe ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Urine Volume ◽  
Maximum Flow ◽  
Controlled Study ◽  
Night Time ◽  
Once Daily ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

AbstractLower urinary tract symptoms are widespread in elderly men and often suggestive of benign prostatic hyperplasia (LUTS/BPH). A randomized, prospective, and open-labeled trial directly comparing the effects of tadalafil (a phosphodiesterase 5 inhibitor) 5 mg once daily and tamsulosin (an α1-blocker) 0.2 mg once daily for 12 weeks in LUTS/BPH patients was conducted. Data were recorded before randomization as well as at 4, 8, and 12 weeks after medication. Fifteen patients allocated tadalafil and 20 allocated tamsulosin completed 12 weeks of medication. Total IPSS, IPSS voiding, and IPSS-QOL scores declined with medication, but there was no difference between drugs. IPSS storage scores reduced more in the tamsulosin group than tadalafil group. OABSS did not decline significantly with medication. IIEF5 was maintained in the tadalafil group, but declined in the tamsulosin group. The maximum flow rate and post-void residual urine volume did not significantly change with medication. Daytime, night-time, and 24-hour urinary frequencies as well as the mean and largest daytime, night-time, and 24-hour voiding volumes per void did not significantly change with medication. In conclusion, tamsulosin was more effective to reduce storage symptoms than tadalafil. Tadalafil had the advantage of maintaining the erectile function.

Understanding an unusual urothelial disorder: cystitis cystica et glandularis

2021 ◽  
pp. 205141582110328
Author(s):  
Harshit Garg ◽  
Prabhjot Singh ◽  
Brusabhanu Nayak ◽  
Rishi Nayyar ◽  
Seema Kaushal ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Bladder Tumour ◽  
Preoperative Imaging ◽  
Urinary Tract Symptoms ◽  
The Mean ◽  
Cystitis Cystica ◽  
Lower Urinary

Objectives: To study the presentation and natural course of cystitis cystica et glandularis. Methods: A retrospective analysis of patients with histopathologically confirmed cystitis cystica et glandularis from March 2016 to March 2018 who at least completed their 2 years’ follow-up was performed. Perioperative details along with the last available follow-up were included in the analysis. Results: A total of 10 patients were included. The mean age (± standard deviation) was 33.4 (±14.0) years and nine (90%) were men. The most common presentation was storage and voiding lower urinary tract symptoms (80%) along with haematuria (40%) and dysuria (20%). Four patients had the presence of hydronephrosis in preoperative imaging, of which three patients had bilateral mild hydroureteronephrosis. All the patients underwent transurethral resection of the bladder tumour as all were diagnosed with urinary bladder mass on preoperative imaging. All the patients had a trigonal lesion with a bullous appearance partially obstructing the bladder neck. Six patients underwent double J stenting in the perioperative period. The mean (± standard deviation) follow-up duration was 32.8 (±7.5) months. Patients were kept on regular surveillance with imaging and cystoscopy as indicated. Eight patients (80%) developed recurrence in the follow-up period. The mean number of recurrences was 1.5 (±1.1). One of the patients had to undergo augmentation ileocystoplasty with bilateral ureteric reimplantation because of the recurrent lesion with small contracted bladder, while another patient underwent cystectomy with urinary diversion owing to recurrence and refractory lower urinary tract symptoms. Besides, there was no evidence of malignancy after this entity in any of the patients. Conclusion: Cystitis cystica et glandularis is a rare clinic pathological entity which often mimics bladder tumour. Cystitis cystica et glandularis is common in men and often presents with lower urinary tract symptoms. Transurethral resection forms the mainstay of treatment. However, it is often associated with upper tract hydronephrosis. Its controversial premalignant nature compounded with recurrence and risk of upper tract deterioration warrants close surveillance. Level of evidence: 4

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