Expected versus experienced pain in office-based flexible cystoscopy: A prospective study.

INTRODUCTION AND

OBJECTIVES

This study prospectively evaluated the relationship between pre-procedural pain expectations and experienced pain during first-time office-based cystoscopy, and assessed whether the discrepancy between them is influenced by age and gender in an outpatient tertiary care setting.

MATERIALS AND

METHODS

This prospective study included adults undergoing first-time office-based cystoscopy between January and April 2026, excluding those with prior cystoscopy or chronic pain requiring analgesics/anxiolytics. All procedures were performed by a single urologist using a 16-Fr flexible cystoscope with intraurethral lidocaine. Expected and experienced pain were assessed using a 0-10 numerical rating scale and analyzed by age and gender, with p < 0.05 considered significant.

RESULTS

A total of 117 patients (83 males, 34 females; mean age 57.6 ± 11.7 years) were included. Post-procedural pain scores were significantly lower than pre-procedural expectations in both male and female patients (all p < 0.001). The magnitude of pain reduction did not differ significantly between male and female patients (p = 0.114) or between patients aged <65 and ≥65 years (p = 0.573). Overall, median pain scores decreased from 6 (5-7) before the procedure to 2 (2-4) after the procedure. Procedure duration was 1.54 ± 0.3 min and did not differ by sex or age. The majority of patients (81.2%) would undergo repeat cystoscopy if required, with no significant difference between male and female patients.

CONCLUSIONS

Patients undergoing office-based cystoscopy report significantly lower pain than anticipated, and these findings may inform clinical counseling by facilitating reassurance and contributing to reduced anxiety through effective pre-procedural education.