RE: Evaluation of hyoscine N-butyl bromide efficacy on the prevention of catheter-related bladder discomfort after transurethral resection of prostate: a randomized, double-blind control trial

International Urology and Nephrology, May 2018

Sudhir Khanna, Ashish Khanna

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RE: Evaluation of hyoscine N-butyl bromide efficacy on the prevention of catheter-related bladder discomfort after transurethral resection of prostate: a randomized, double-blind control trial

RE: Evaluation of hyoscine N‑butyl bromide efficacy on the prevention of catheter‑related bladder discomfort after transurethral resection of prostate: a randomized, double‑blind control trial Sudhir Khanna 0 1 Ashish Khanna 0 1 0 PGIMER , Chandigarh , India 1 Department of Urology, Sir Ganga Ram Hospital , New Delhi 110060 , India The authors have not reflected anywhere in the paper the number of injections of meperidine required in a given patient whether it is the treatment group or control group. Size of the urethra, whether narrow, optical internal urethrotomy (OIU) was done or not, and which size resectoscope was used have not been taken into consideration, and these factors can cause pain. The patients were controlled with placebo and not with oxybutynin, etc., as written in the first paragraph of page 1908. In randomization, how did they convince patient for no treatment versus treatment? Or they have hidden something in the consent form. - Editor, Authors and affiliations Golnar Sabetian, Farid Zand, Elham Asadpour, Mohammad Ghorbani, Pourya Adibi, Mohammad Mehdi Hosseini, ShahryarZeyghami, Farzaneh Masihi. International Urology and Nephrology November 2017, Volume 49, Issue 11, pp 1907–1913 I think the title itself is a misnomer. Prevention of a thing is done before the insult. Here the drug hyoscine is given after the transurethral resection of the prostate, so it cannot be called prevention in true sense. The biggest lacuna of the paper is that cases have been operated on under general anaesthesia (GA). They have been given midazolam and fentanyl. We fail to understand the combination of fentanyl and morphine in a given patient which we normally do not give, as both are analgesics. Coming to the duration of action of midazolam, which is 1–6 h, and of morphine, which is 3–7 h, then how come one can assess the catheter-related bladder discomfort (CRBD) degree in any given patient, that too in immediate post-operative period? Most important is no sedation score has been considered in these patients who have undergone surgery under general anaesthesia. We all know two patients of different scores are not comparable. CRBD degree has to have fine perception of a given patient, and unless the effect of GA drugs have weaned off, how can one comment? Compliance with ethical standards Conflict of interest The authors declare that they have no conflict of interest. Ethical standards All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Human and animal rights This article does not contain any studies with animals performed by any of the authors. Informed consent Informed consent was obtained from all individual participants included in the study.


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Sudhir Khanna, Ashish Khanna. RE: Evaluation of hyoscine N-butyl bromide efficacy on the prevention of catheter-related bladder discomfort after transurethral resection of prostate: a randomized, double-blind control trial, International Urology and Nephrology, 2018, 1-1, DOI: 10.1007/s11255-018-1864-3