The effect of lubricants used in indwelling bladder catheterization through urethra on procedure-related pain: a literature review

Objectives: The scope of this review was various lubricants used to mitigate pain during urethral catheterization procedure and it was performed in order to review the published studies and to examine the data obtained from those studies in a systematic way. Methods: The study was performed through retrospective scan of related publications using the keywords “urinary catheterization (urethral catheterization, foley catheterization)” and “pain” on the databases Pubmed, OVID-LWW, Scopus, Taylor & Francis, Science Direct EBSCHO, Medline Complete, Cochrane Library, and ULAKBIM and grey literature scan. The studies obtained were assessed by the researchers separately using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (MAStARI). Results: At the end of the scan, 1428 publications were reviewed. 13 publications that met the research inclusion criteria were assessed as full texts and 7 publications that were randomized controlled double-blind, randomized controlled single-blind and cross-sectional analytic were taken into the study scope. At the end of the systematic examination, it was determined that the level of pain caused when inserting a urinary catheter using lidocaine gel was 8.7 mm at the lowest and 38 mm at the highest, while the pain level that occurs when distilled water-or waterbased lubricant is used is 19.3 mm at the lowest and 58 mm at the highest. The gel used was directly influential on pain and the level of pain in male and young patients was higher. It was found out that there was no relation between procedure-related pain and prior catheter implementation in the patient, the number of interventions applied to implement catheter, the number of catheter, bleeding during implementing catheter, use of post-operative analgesia, and the existence of urinary retention and prostate. Conclusion: Urethral catheterization procedure ranks among the first in invasive interventions that might cause pain in patients and the level of pain felt can rise to severe level. Thus, it is possible in patients without allergy to minimize the level of pain felt by using gels containing lidocaine in line with the standards of implementation regardless of gender and age. In order to raise the level of generalizability and to provide evidence, comparative studies are needed in which catheterization is implemented by the same implementer with similar patient groups and the same procedure steps.