Bibliographic record
Abstract
Introduction: Effective analgesia for patients undergoing intravesical botulinum toxin (BoNT) is not well-studied.Pre-procedural bladder instillation of lidocaine solution remains standard practice but does require significant time and resources.The primary objective of this study is to compare pain scores immediately following intravesical BoNT using pre-procedural intravesical lidocaine instillations and lidocaine gel vs lidocaine lubricating gel alone.Methods: All patients with intact bladder sensation undergoing BoNT between March 1 and September 1,2022, were included.Prior to June 1, patients received intravesical 2% lidocaine solution instillation for 30 minutes and lidocaine gel immediately prior to treatment (group 1).After June 1, patients received lidocaine gel (Instillagel) alone (group 2).The visual analogue pain score (VAS) was used to measure patient reported pain immediately following BoNT.Treatment failure was defined as patient requesting to stop treatment during the procedure or patient request to perform future treatments under sedation.Patient demographics, postprocedural complications, and treatment failures were collected by prospective chart review and compared using t-test and Chi-squared test.The Mann-Whitney U test was used to compare pain scores between treatment groups.Results: A total of 80 patients were included (mean age 61 years, 75% female, 56% with overactive bladder, 30% receiving first treatment).Thirty-nine patients (49%) were included in group 1 and 41 patients (51%) in group 2. There were no significant differences in baseline characteristics between treatment groups (p>0.05).There was no significant difference in overall pain scores between groups: group 1 median VAS 3.0 vs. group 2 median VAS 4.0 (p=0.11).There was no significant difference in pain scores by sex, indication for treatment, or first vs.subsequent BoNT treatment (p>0.05).Post-procedural complications occurred in four patients in group 1 (three UTI, one hematuria) compared to two patients in group 2 (two UTI).Treatment failure did not occur in either group.Conclusions: The use of lidocaine lubricating gel alone immediately before BoNT provided comparable pain control to traditional pre-procedural lidocaine solution instillation and lidocaine gel.There were no treatment failures and complications were low in both groups.The use of lidocaine gel alone may be an acceptable analgesia alternative while improving efficiency of treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.251 | 0.219 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".