Does 2% Lignocaine Gel Reduce Urethral Catheterisation Pain in Women? A Systematic Review and Meta‐Analysis

Abstract

Urinary catheterisation is an important aspect of patient care yet commonly causes discomfort or pain. Current international guidelines recommend water‐based sterile lubricant during catheterisation of women, whereas local anaesthetic gel (e.g., lignocaine gel) is advocated in men, potentially highlighting a gender bias in clinical care. The purpose of this systematic literature review was to evaluate the effectiveness of 2% lignocaine gel compared to water‐based lubricant in reducing pain during urethral catheterisation of women. A systematic search using key terms and their alternate spellings was used to identify relevant studies. Studies were included that examined the use of 2% lignocaine during urethral catheterisation of women. This review searched Cochrane Library, Cumulated Index in Nursing and Allied Health Literature (CINAHL), Emcare Nursing and Allied Health Database, Excerota Medica Database (EMBASE), Maternity and Infant Care Database, MEDLINE, OVID, ProQuest, PubMed and SCOPUS. In addition, clinical trial and systematic review registries were also searched from inception to May 2025. A total of 2030 studies were identified and screened. Three randomised controlled studies involving 214 female participants were included in this review. Pooled results indicated a statistically significant difference in favour of 2% lignocaine gel compared to water‐based lubricant during urethral catheterisation in women (mean difference −10.81, 95% CI: −15.81 to −5.35). The application of 2% lignocaine gel is more effective in reducing catheterisation‐associated pain in women compared to water‐based lubricant. Current clinical guidelines suggest the use of a water‐based lubricant for women, but an anaesthetic‐based lubricant for men. The belief that women do not require local anaesthesia before catheterisation may be influenced by historical perspectives and warrants further investigation.