Introduction
Cystoscopy is one of the most common outpatient procedures of urologic
practice that provides to evaluate lower urinary tract diseases such as
various pathologies of urethra, prostate and bladder(1). A Flexible instrument used cystoscopy was first
introduced by Tsuchida and Sugawara in 1973. They reported that flexible
cystoscopy was a potentially less painful technique than rigid
cystoscopy, especially in male patients (2). Since
then flexible cystoscopy has been performed routinely in many urology
clinics and European Association of Urology guidelines recommend
flexible instruments for cystoscopy, particularly in men(3). The guidelines report that flexible cystoscopy
with local anesthetic instillation results in better compliance compared
to rigid cystoscopy. However the meta-analysis regarding this
recommendation do not compare between rigid and flexible cystoscopies.
It compares only flexible cystoscopies with and without topical intra
urethral anesthetic instillations (4).
Only two studies have compared pain and tolerability of male patients
during flexible and rigid cystoscopies (5,6). The
results of these studies showed that flexible cystoscopy was better
tolerated and it caused less pain than rigid cystoscopy by male
patients. However the most important limitation of the both studies is
that the different diameter instruments were compared. The diameters of
the rigid cystoscopes were bigger than the diameters of the flexible
cystoscopes in the both studies. The aim of the present study was to
compare lower urinary tract symptoms (LUTS), sexual functions and
quality of life as well as pain and tolerability between flexible and
rigid cystoscopies which had the same diameter in male patients with
non-muscle invasive bladder cancer (NMIBC).