Introduction: Cystoscopy is one of the most common procedures in outpatient urology. Although flexible cystoscopes are more tolerable, rigid cystoscopes have still been used in many clinics because of their lower costs, better visual performance, and easier handling. It can be difficult to achieve optimal relief of pain and anxiety during rigid cystoscopy. The aim of the present prospective randomized study was to evaluate the efficacy of hypnosis as an adjunct to routine local anesthesia in reducing pain and anxiety in rigid cystoscopy patients. Materials and Methods: Ninety male patients undergoing rigid cystoscopy for the first time were randomized into two groups: (1) Hypnosis Group (Group H) patients underwent cystoscopy with hypnotic communication as an adjuvant approach for periprocedural analgesia and anxiety, (2) Standard Care Group (Group SC) patients underwent cystoscopy with routine local anesthesia and lubrication as control group. The data were collected using visual analog scale (VAS) for pain, State-Trait Anxiety Inventory (STAI) for anxiety and hemodynamic parameters. Furthermore, a VAS was also completed by the urologist to assess his satisfaction. Results: Baseline characteristics, STAI, hemodynamic parameters, and recovery duration were statistically similar between the two groups. The procedure duration was shorter in Group H (p = 0.018). The postprocedural STAI and VAS scores of patients in Group H were significantly lower than those of Group SC (p = 0.006; p = 0.02, respectively). Heart rate and mean arterial pressure after positioning of the patient (p = 0.000; p = 0.004, respectively) and insertion of the cystoscope (p = 0.000; p = 0.000) were statistically lower in Group H, whereas baseline, postprocedural, and predischarge hemodynamic measurements were similar. Urologists were also more satisfied in Group H (p = 0.000). Conclusion: Hypnosis as an adjunct therapy to local anesthesia during rigid cystoscopy significantly reduces pain and anxiety, provides more stable hemodynamic conditions, shortens procedure duration, and thus appears attractive for pain and anxiety management.
Keywords: anxiety; hypnosis; pain; rigid cystoscopy.