Diclofenac Suppository to Control Pain During Flexible Cystoscopy

NCT ID: NCT01812928

Last Updated: 2013-12-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-03-31

Study Completion Date

2013-08-31

Brief Summary

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Flexible cystoscopy has diagnostic as well as therapeutic role in many patients presenting in urology clinic with lower urinary tract symptoms (frequency, nocturia etc) and hematuria (blood in urine).

Pain associated with cystoscopy varies from patient to patient, majority requires local anesthesia or lubricant solution only. During flexible cystoscopy, lubrication, use of topical anesthesia and duration of cystoscopy are recognized as important factors contributing in severity of pain of which use of intraurethral gel left to individual preference. Various studies are available reporting the pain perception with use of various intraurethral gels. Even the highest level of evidence is unable to resolve the query.

With this study the investigators hypothesize that pain perception (recorded in form of pain score) during flexible cystoscopy can be reduced with use of per operative diclofenac(Non Steroidal Anti Inflammatory Drug)suppository in comparison to plain gel alone.

With better control of pain the investigators aim to increase patient comfort and compliance which will increase the patient satisfaction rate and early return to work.

Detailed Description

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Conditions

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Pain Hematuria Lower Urinary Tract Symptoms

Keywords

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Flexible Cystoscopy Pain control Diclofenac Non steroidal anti inflammatory drug

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Caregivers Outcome Assessors

Study Groups

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Gel only

This group will be given only intraurethral gel during flexible cystoscopy.

Group Type NO_INTERVENTION

No interventions assigned to this group

Diclofenac and Gel

This group will also receive intraurethral gel during cystoscopy but additionally diclofenac suppository will be given per rectally one hour before procedure as preemptive analgesia.

Group Type EXPERIMENTAL

Diclofenac

Intervention Type DRUG

Interventions

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Diclofenac

Intervention Type DRUG

Other Intervention Names

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Non steroidal anti-inflammatory drug

Eligibility Criteria

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Inclusion Criteria

* All male patients aged 18 and above
* Visiting for evaluation of Haematuria or
* Lower urinary tract symptoms (which include poor steam of urine,intermittency, hesitancy, incomplete voiding of urine, increase urgency, increase frequency, nocturia and urge incontinence)
* For removal of double J ureteral stent will be included in the study.

Exclusion Criteria

* Patients with clinical evidence of urethral stricture and/or prostatitis,
* Patients in which biopsy will be taken,
* those having psychiatric illness,
* Asthmatics
* Kidney, liver disease
* Those allergic to NSAIDs (non-steroidal anti-inflammatory drugs)
* Those who refuse to participate,
* Having history of chronic analgesia use or
* Having language barrier will be excluded.
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

Yes

Sponsors

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Aga Khan University

OTHER

Sponsor Role lead

Responsible Party

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Dr.Mehwash Nadeem

Resident

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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mehwash nadeem, M.B.,B,S

Role: PRINCIPAL_INVESTIGATOR

Aga Khan University

Locations

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Aga Khan University Hospital

Karachi, Sindh, Pakistan

Site Status

Countries

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Pakistan

References

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Kobayashi T, Nishizawa K, Mitsumori K, Ogura K. Instillation of anesthetic gel is no longer necessary in the era of flexible cystoscopy: a crossover study. J Endourol. 2004 Jun;18(5):483-6. doi: 10.1089/0892779041271535.

Reference Type BACKGROUND
PMID: 15253827 (View on PubMed)

Goldfischer ER, Cromie WJ, Karrison TG, Naszkiewicz L, Gerber GS. Randomized, prospective, double-blind study of the effects on pain perception of lidocaine jelly versus plain lubricant during outpatient rigid cystoscopy. J Urol. 1997 Jan;157(1):90-4.

Reference Type BACKGROUND
PMID: 8976223 (View on PubMed)

Herr HW, Schneider M. Immediate versus delayed outpatient flexible cystoscopy: final report of a randomized study. Can J Urol. 2001 Dec;8(6):1406-8.

Reference Type BACKGROUND
PMID: 11788018 (View on PubMed)

Tzortzis V, Gravas S, Melekos MM, de la Rosette JJ. Intraurethral lubricants: a critical literature review and recommendations. J Endourol. 2009 May;23(5):821-6. doi: 10.1089/end.2008.0650.

Reference Type BACKGROUND
PMID: 19397430 (View on PubMed)

Aaronson DS, Walsh TJ, Smith JF, Davies BJ, Hsieh MH, Konety BR. Meta-analysis: does lidocaine gel before flexible cystoscopy provide pain relief? BJU Int. 2009 Aug;104(4):506-9; discussion 509-10. doi: 10.1111/j.1464-410X.2009.08417.x. Epub 2009 Feb 23.

Reference Type BACKGROUND
PMID: 19239453 (View on PubMed)

Patel AR, Jones JS, Babineau D. Lidocaine 2% gel versus plain lubricating gel for pain reduction during flexible cystoscopy: a meta-analysis of prospective, randomized, controlled trials. J Urol. 2008 Mar;179(3):986-90. doi: 10.1016/j.juro.2007.10.065. Epub 2008 Jan 18.

Reference Type BACKGROUND
PMID: 18206920 (View on PubMed)

Komiya A, Endo T, Kobayashi M, Kim W, Araki K, Naya Y, Suzuki H, Tobe T, Ichikawa T, Fuse H. Oral analgesia by non-steroidal anti-inflammatory drug zaltoprofen to manage cystoscopy-related pain: a prospective study. Int J Urol. 2009 Nov;16(11):874-80. doi: 10.1111/j.1442-2042.2009.02384.x. Epub 2009 Sep 24.

Reference Type BACKGROUND
PMID: 19780869 (View on PubMed)

Idkaidek NM, Amidon GL, Smith DE, Najib NM, Hassan MM. Determination of the population pharmacokinetic parameters of sustained-release and enteric-coated oral formulations, and the suppository formulation of diclofenac sodium by simultaneous data fitting using NONMEM. Biopharm Drug Dispos. 1998 Apr;19(3):169-74. doi: 10.1002/(sici)1099-081x(199804)19:33.0.co;2-c.

Reference Type BACKGROUND
PMID: 9570000 (View on PubMed)

Other Identifiers

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122010SUR

Identifier Type: -

Identifier Source: org_study_id