Re: Pressure Makes Pleasure: A Preliminary Study of Increasing Irrigation Pressure of Flexible Cystoscopy Improves Male Patient Comfort by an Easy Way

available at http://www.ncbi.nlm.nih.gov/pubmed/25603481 Editorial Comment: It has always been my observation that increasing the irrigation pressure during office flexible cystoscopy facilitates male flexible cystoscopy, as the irrigation fluid may distend the urethra and/or sphincter to allow for easier passage of the flexible cystoscope. I will routinely ask my medical assistant to manually squeeze the saline bag during cystoscopy. In this nice randomized study the authors examined whether increasing the irrigation pressure during flexible cystoscopy resulted in decreased discomfort for male patients undergoing flexible cystoscopy. The height of the saline bag was randomized to 80, 100 and 150 cm above the examination table, and visual analogue scales were recorded. The group with the highest irrigation pressure (150 cm) had significantly less discomfort during cystoscopy. Thus, this simple modification seems to decrease discomfort for males undergoing office flexible cystoscopy.