Evaluation of anxiety, embarrassment, and pain associated with cystoscopy in the operating room: a male population sample

Özhanlı, Yasemin; Türkmen, Açelya; Alkay, Nadiye; Soytaş, Duygu; Yücetaş, Uğur

doi:10.1590/1806-9282.20250888

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Original Article • Rev. Assoc. Med. Bras. 71 (11) • 2025 • https://doi.org/10.1590/1806-9282.20250888 linkcopy

Evaluation of anxiety, embarrassment, and pain associated with cystoscopy in the operating room: a male population sample

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE: The aim of this study was to determine the anxiety, embarrassment, and pain levels of patients undergoing a cystoscopy procedure.

METHODS: This cross-sectional study was conducted on 151 male patients who underwent cystoscopy in a hospital operating room between October 2021 and 2022. Data were collected with the Beck Anxiety Inventory for anxiety in preoperative; the Numeric Rating Scale for anxiety, embarrassment, and pain in intraoperative.

RESULTS: The mean score of the patients’ Beck Anxiety Inventory was 3.810±6.905; the mean scores of the first and second Numeric Rating Scale measurements were 1.79±1.23; 1.94±1.28 for anxiety; 2.77±2.54; 2.32±2.30 for embarrassment; 1.44±0.75; 3.46±2.15 for pain, respectively. As a result of the regression analysis, the anxiety levels of the patients before the procedure explained 15.2 and 38.6% of the embarrassment and pain levels during the procedure, respectively.

CONCLUSION: Anxiety, embarrassment, and pain levels of the patients in terms of the cystoscopy procedure were related to each other, and these parameters varied during different steps of the procedure.

KEYWORDS:
Pain; Embarrassment; Anxiety; Cystoscopy

Measures		T0_BAI	T1e	T2e	T1a	T2a	T2p	T3p
T0_BAI	R	1.000
T0_BAI	P	0.000
T1e	R	0.320**	1.000
T1e	P	0.000	0.000
T2e	R	0.397**	0.875**	1.000
T2e	P	0.000	0.000	0.000
T1a	R	0.370**	0.460**	0.444**	1.000
T1a	P	0.000	0.000	0.000	0.000
T2a	R	0.635**	0.434**	0.470**	0.673**	1.000
T2a	P	0.000	0.000	0.000	0.000	0.000
T2p	R	0.297**	0.252**	0.233**	0.524**	0.476**	1.000
T2p	P	0.000	0.002	0.004	0.000	0.000	0.000
T3p	R	0.624**	0.390**	0.427**	0.290**	0.497**	0.248**	1.000
T3p	P	0.000	0.000	0.000	0.000	0.000	0.002	0.000

Independent variable	Unstandardized coefficients		Standardized coefficients	t	p	95%CI
Independent variable	B	SE	β	t	p	Alt	Top
Fixed	2.319	0.225		10.299	<0.001	1.874	2.764
Beck Anxiety Score	0.118	0.029	0.320	4.119	<0.001	0.061	0.174
*Dependent variable=T1e, r=0.320; R²=0.096; F=16.963; p=0.000; Durbin Watson Value=1.943
Fixed	1.788	0.199		8.964	<0.001	1.394	2.182
Beck Anxiety Score	0.134	0.025	0.397	5.280	<0.001	0.084	0.184
*Dependent variable=T2e, r=0.397; R²=0.152; F=27.880; p=0.000; Durbin Watson Value=2.078
Fixed	0.512	0.129		3.982	<0.001	0.258	0.766
Beck Anxiety Score	0.062	0.016	0.297	3.794	<0.001	0.030	0.094
*Dependent variable=T2p, r=0.297; R²=0.082; F=14.397; p=0.000; Durbin Watson Value=1.768
Fixed	2.722	0.157		17.342	<0.001	2.412	3.032
Beck Anxiety Score	0.195	0.020	0.624	9.756	<0.001	0.155	0.234
*Dependent variable=T3p, r=0.624; R²=0.386; F=95.180; p<0.001; Durbin Watson Value=1.842

		n	T0_BAI	T1e	T2e	T1_a	T2_a	T2p	T3p
		n	Mean±SD	Mean±SD	Mean±SD	Mean±SD	Mean±SD	Mean±SD	Mean±SD
BMI	Normal	46	9.830±6.650	3.370±2.594	2.780±2.356	1.951±1.720	2.149±1.960	1.697±0.910	3.870±2.500
	Overweight	75	5.228±2.930	2.611±2.470	2.427±2.120	1.695±1.070	1.889±1.120	1.236±0.650	3.470±2.088
	Obese	30	2.684±1.630	2.600±2.207	2.000±1.965	1.676±0.870	1.450±0.630	1.530±0.730	2.830±1.577
F			6.426	1.896	1.470	2.684	4.933	0.460	2.134
p			0.002 *	0.154	0.233	0.072	0.008 *	0.632	0.122
Post-hoc			1>2, 1>3				1>2, 1>3
Reason for cystoscopy	Abduction Impulse	10	2.600±2.757	3.500±2.635	2.800±1.932	1.300±1.567	1.947±1.700	1.350±0.600	2.600±2.547
	Retention	25	5.835±3.280	3.200±2.533	2.480±2.201	1.675±0.840	1.528±0.800	1.044±0.560	3.640±1.655
	Hematuria	23	8.508±3.130	3.130±2.380	2.520±2.108	2.172±2.090	2.020±1.520	2.066 ±1.780	3.300±2.285
	Routine Monitoring	69	7.253±4.330	2. 653±2.410	2. 471±2.120	1.654±1.000	2.007±1.130	0.953±0.280	3.260±2.048
	Stent removal	24	6.737±4.00	2.710±2.386	2.502 ±2.210	1.840±1.420	2.064±1.790	1. 663±1.380	4.380±2.464
F			0.268	0.852	0.316	2.014	1.105	7.049	1.737
p			0.898	0.495	0.867	0.095	0.357	0.000 *	0.145
Post-hoc								3>1, 3>2, 3>4, 5>2, 5>4
Number of cystoscopy	First	53	7.873±4.550	3.080±2.409	2.750±2.401	1.758±1.150	1.889±1.170	1.464±0.830	3.890±2.309
	Second	18	9.083±4.830	3.220±2.713	2.560±2.202	2.279±1.610	2.437±1.940	2.191±1.720	3.890±1.711
	Third	19	3.025±2.530	2.859±2.790	2. 353±2.260	1.686±1.210	2.065±1.470	1.003±0.320	2.890±2.283
	>3	61	6.142±3.260	2. 517±2.360	2.260±1.840	1.727±1.180	1.799±1.110	1.134±0.520	3.150±2.040
F			0.676	0.968	1.572	0.317	0.964	4.084	1.826
p			0.568	0.409	0.199	0.813	0.411	0.008 *	0.145
Post-hoc								2>1, 2>3, 2>4
Cystoscope type and number	Rigid (17 Fr)	92	4.460±7.616	3.090±2.646	2.500±2.411	1.837±1.250	2.134±1.340	1.279±0.540	3.800±2.165
	Rigid (>17 Fr)	21	4.290±6.849	2.373±2.330	2. 406±2. 100	1.729±1.240	1.806±1.480	1.430±1.399	4.050±2.312
	≥Flexible (17 Fr)	38	1.970±4.541	2.240±2.318	2.071±1.920	1.763±1.160	1.515±1.030	1.727±0.870	2.320±1.596
F			1.817	1.876	0.922	0.036	0.465	3.504	8.007
p			0.166	0.157	0.400	0.965	0.629	0.033 *	0.000 *
Post-hoc								2>1	1>3, 2>3

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[TFN1] ^**
<0.01; Pearson correlation analysis. **T1: Trendelenburg position; T2: cystoscope insertion; T3: cystoscope removal.