ArticleHealthcare (Basel, Switzerland)2026
Patient-Reported Pain and Satisfaction During Flexible Cystoscopy in Supine Versus Lithotomy Positions in Adult Men: A Retrospective Observational Study.
Article in Healthcare (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSupine flexible cystoscopy is already established in routine urological practice. However, real-world patient-reported pain across specific procedural stages and other patient-centered outcomes according to clinician-selected procedural position remain incompletely characterized. This study evaluated the associations of supine and lithotomy positioning with patient-reported and procedural outcomes in adult men undergoing flexible cystoscopy. MATERIALS AND
methodsThis multicenter retrospective observational study included 80 adult male patients who underwent flexible cystoscopy under local anesthesia. Procedural position was selected by the treating urologist according to clinical feasibility and routine clinical judgment, including the patient's ability to assume the lithotomy position. Patients were classified according to the position used during the procedure as supine (
resultsA total of 80 patients were included (40 supine and 40 lithotomy). Mean VAS scores were lower in the supine group during cystoscope insertion (2.1 ± 1.0 vs. 3.4 ± 1.2; mean difference [MD]: -1.30, 95% CI: -1.79 to -0.81;
conclusionsIn this retrospective, non-randomized cohort, clinician-selected supine positioning was associated with lower reported pain and higher procedural tolerance and satisfaction compared with lithotomy positioning. No statistically significant between-group differences were observed in overall procedural success or complication rates. Because position selection was clinician-directed and potentially influenced by patient mobility and other unmeasured factors, these findings do not demonstrate a causal benefit of supine positioning. They should be considered hypothesis-generating and require confirmation in adequately powered prospective randomized studies before informing changes in routine clinical practice.
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