A new small-calibre diagnostic flexible cystoscope

Objective To determine whether flexible cystoscopy with a prototype slim flexible instrument is less uncomfortable than flexible cystoscopy using a standard flexible cystoscope. Patients and methods In all, 200 men scheduled to undergo flexible cystoscopy for the follow-up of transitional cell carcinoma of the bladder were randomized in equal groups to flexible cystoscopy using the standard instrument or using the prototype slim-scope. Each patient had 11 mL of 21% lignocaine gel instilled intraurethrally 5 min before the procedure. At the end of the procedure the patient was asked to complete a 100-mm non-graphical visual analogue scale to rate how uncomfortable the procedure was. Results The slim-scope was very significantly less uncomfortable than the conventional instrument (ANOVA P<0.001). The case of use and views of the bladder were similar to those obtained with the conventional cystoscope, Conclusion The slim-scope offers a significant benefit in patient comfort, with little loss of image quality or case of use.