The Effects of Listening to Music on Anxiety, Pain, and Satisfaction during Urodynamic Study: A Randomized Controlled Trial.

INTRODUCTION: To assess the influence of music therapy on perceived anxiety and pain during outpatient urodynamic study (UDS) in a prospective, randomized fashion. METHODS: Between January and December 2018, a total of 70 patients were randomized to either have music therapy (study) or not have (control) in a 1:1 ratio. To the study group, Sufi music was delivered at low tempo. All participants performed the State-Trait Anxiety Inventory evaluation after the procedure and assessed their degree of pain, satisfaction, and willingness to undergo an additional or repeat procedure using the Visual Analog Scale. RESULTS: Patient demographic and baseline characteristics were found to be similar between the 2 groups. Though music did not significantly alleviate pain (4.6 ± 1.2 vs. 4.4 ± 1.7; p = 0.76) and anxiety (47.7 ± 7.75 vs. 46.4 ± 6.5; p = 0.36), it had a positive impact on the patient's willingness to repeat UDS (3.4 ± 1.4 vs. 6.1 ± 1.3; p = 0.005) and provided overall satisfaction (4.6 ± 0.61 vs. 7.2 ± 1.33; p = 0.004). CONCLUSIONS: Music is a practical, harmless, and inexpensive non-pharmacological option that can be adopted during medical and surgical procedures, although according to this present study, listening to music during UDS had no effect on pain and anxiety levels.

Effectiveness of D-mannose, Hibiscus sabdariffa and Lactobacillus plantarum therapy in prevention of infectious events following urodynamic study.

INTRODUCTION AND AIM: The urodynamic study is an invasive examination that allows a thorough evaluation of the functional activity of the lower urinary tract (bladder, urethra). The execution of urodynamic study exposes the patient to the risk of contracting infections of the lower urinary tract. Prevention of urinary tract infections consists in the avoidance of risk factors and prophylaxis with antimicrobial and non-antimicrobial measures. In this article, we aimed to evaluate the effectiveness of a phytotherapeutic product composed of D-mannose, Hibiscus sabdariffa, and Lactobacillus plantarum in the prevention of infectious events following invasive urodynamic examination. MATERIALS AND METHODS: We selected 100 female consecutive patients (age 19-87 years) that underwent urodynamic invasive procedure. We prescribed 14-day therapy with D-mannose, H. sabdariffa, and L. plantarum to these 100 patients after urodynamic invasive test. After that, we have examined urine cultures and urinary symptoms through telephone interviews and hospital outpatient visits to evaluate the possible presence of urinary tract infections. RESULTS: Urinary tract infections were observed through urine culture in 13% of the selected patients; of the 13 urinary tract infections, 9 were observed in patients with urinary tract recurrent infections in the last year and the other 4 cases were associated with patients with no urinary infection in the last year. Three women reported some urinary symptoms and underwent antibiotic therapy. The other 10 cases were classified as asymptomatic bacteriuria. Three cases were related to patients presenting with pelvic organ prolapse. Eight cases were instead related to significant post-voiding residue (>100). Six patients with urinary tract infection reported constipation in the last year. All patients completed the prescribed therapy due to the affordable price of the product and no side effects have been reported. CONCLUSION: Our study about the administration of D-mannose, H. sabdariffa, and L. plantarum after invasive urodynamic examination underlined how this phytotherapeutic product can reduce the risk of bacteriuria and urinary tract infection in women.

The effects of a heating pad on anxiety, pain, and distress during urodynamic study in the female patients with stress urinary incontinence.

AIMS: Although generally well tolerated, a urodynamic study is an unpleasant and stressful procedure for some patients. This study evaluated the effects of a heating pad on anxiety, pain, and distress during urodynamic studies in female patients with stress urinary incontinence. METHODS: A total of 74 female patients with stress urinary incontinence who underwent a urodynamic study between May 2015 and October 2015 were randomized to either the experimental group using a heating pad (n = 37) or control group (n = 37). In the experimental group, a heating pad was applied on the patient's sacrum during the urodynamic study. All patients completed the State-Trait Anxiety Inventory (20-80) before and after the procedure and assessed their degree of pain and distress after the procedure by the visual analog scale (0-10). Systolic and diastolic blood pressure and pulse rate were also checked before and after the procedure. RESULTS: Demographic characteristics, mean age, procedure duration, pre and post-procedural systolic, and diastolic blood pressures, and pulse rate were statistically similar between the experimental and control groups. The mean State-Trait Anxiety Inventory was significantly lower in the experimental group than in the control group (30.9 ± 7.5 vs 42.5 ± 10.1, P < 0.001). The experimental group showed significantly lower pain and distress scores (Visual Analog Scale, 2.7 ± 1.5, 3.0 ± 1.5) compared with the control group (4.0 ± 1.6, 4.7 ± 2.0, both P < 0.001). CONCLUSIONS: Using a heating pad for female patients with stress urinary incontinence during a urodynamic study is a simple, economical, and effective therapy that enhances patient comfort and decreases anxiety, pain, and distress.

Effectiveness of ciprofloxacin prophylaxis in preventing bacteriuria caused by urodynamic study: a blind, randomized study of 192 patients.

OBJECTIVES: To determine the efficacy of prophylactic ciprofloxacin in preventing urinary tract infections caused by urodynamic study (UDS). METHODS: A total of 210 patients presenting for UDS during a 16-month period were offered enrollment in the study. A clean-catch midstream urine sample was taken 24 hours before and 48 to 72 hours after the procedure and after microscopic examination and culture were done. All patients underwent a standard UDS. The 192 patients who had sterile urine before intervention were included in the study. Randomly, 98 of the 192 patients were orally given 500 mg of ciprofloxacin 1 hour before the urodynamic intervention and 94 were not given anything. The patients who were found to have significant bacteriuria after UDS were followed up and treated properly. RESULTS: Eighteen patients (8.6%) who had significant bacteriuria in the urine culture before UDS were excluded from the study. The rate of significant bacteriuria in the urine culture after UDS was 7.3% overall, 1% in the prophylaxis group, and 14% in the controls, a significant difference (P = 0.002). The most common uropathogen was Escherichia coli (57%). Three independent risk factors were identified: not giving antibiotic prophylaxis before UDS; antibiotic use in the preceding month; and the presence of pyuria before UDS. CONCLUSIONS: Urinary tract infections after UDS decreased from 14% to 1% with a single dose of ciprofloxacin 500 mg orally before UDS. We recommend antibiotic prophylaxis for patients undergoing a UDS.