Nitrous Oxide for Analgesia During Office Urethral Bulking

Exclusion Criteria

• •\< 18 years old
• •prior urethral bulking therapy
• •predominant urge incontinence symptoms
• •contraindications to nitrous oxide
• •pre-existing significant cardiopulmonary disease
• •hypotension defined as systolic blood pressure (BP) \< 90 or diastolic BP \<50 on initial BP in the office
• •chronic pain disorders (specifically fibromyalgia, chronic pelvic pain, sciatica or chronic low back pain, painful bladder syndrome)
• •chronic narcotic use (defined as taking a narcotic medication \>3 days per week during the past two weeks)
• •pregnancy
• •conditions of air trapping (bullous emphysema, bowel obstruction, pneumothorax, intracranial air, middle ear conditions, status post recent diving, recent eye surgery)
• •lidocaine allergy
• •neurologic diseases impairing pain perception.