Iontophoresis as a new method of delivering local anesthesia to the urethra: a pilot study.

OBJECTIVES

To test the feasibility of using the iontophoretic catheter as a means of delivering local anesthetic (lidocaine hydrochloride) to the urethra for periurethral injection of collagen.

METHODS

Eight women with urodynamically proven genuine stress incontinence underwent periurethral collagen injections. Local anesthesia was provided by 4% lidocaine with 1 in 100,000 epinephrine administered over 10 minutes using an iontophoretic catheter. Pain was assessed by Likert and visual analogue scales. Cystoscopic appearance of the urethra was noted.

RESULTS

The periurethral bulking procedure was completed without further anesthetic in 7 women, 1 of whom had no pain. There was no evidence of urethral damage from the iontophoresis.

CONCLUSIONS

Iontophoresis shows promise as a method of providing analgesia to the urethra. However, the degree of analgesia is variable, and further research is needed on catheter design to ensure transport of anesthetic agent into the periurethral tissues.