Pain Associated With Urethral Catheterization Is Reduced in Males by Simultaneous Voiding Maneuver

Objective To assess whether urethral pain during male catheterization can be reduced if the patient is instructed to void during the insertion of the catheter. Methods Ninety-six males (age 66 ± 13) who were referred for multichannel urodynamic study were prospectively randomized to 2 groups according to the catheter insertion technique: (1) patients who were instructed to void during catheterization, and (2) patients who had no guidance prior or during catheterization. Exclusion criteria were the following: use of analgesics within the previous 24 hours, active urinary tract infection, indwelling urethral catheter, pre-existing urethral pain, and known urethral stricture or inability to cooperate with pain assessment due to mental disorders. A 0 to 10 visual analog pain scale was filled in different time points: prior and immediately after instillation of the lubricant gel into the urethra, immediately after the insertion of the catheter, and 15 minutes after the test. Results Study groups did not differ in terms of demographic, clinical, and urodynamic parameters. The median visual analog pain scale during catheterization was 2 (interquartile range 1-3) and 4 (interquartile range 3-5) in groups 1 and 2, respectively (P <.001). There were no differences in the reported scores in the other checkpoints. Conclusion Pain level during urethral cauterization in males can be significantly reduced when the patient is instructed to void during the insertion of the catheter into the urethra.