Supplementary Table 2.

Summary of studies evaluating the use of electromotive drug administration prior to transurethral procedures

Study	Treatment regime	Comparator group	Study end points	Outcome
Dasgupta 1998	Prior to intravesical capsaicin for detrusor hyperreflexia	EMDA lidocaine and epinephrine 20 mA for 15 min (75 ml lidocaine hydrochloride 4% with 75 ml sterile water and 1.5 ml 1:1000 epinephrine)	N/A	Lower pain scores during capsaicin instillations versus when lidocaine alone had been used in previous studies EMDA eliminated hyperreflexic contractions of bladder during capsaicin instillations so reduced the risk of leakage and prevented autonomic dysreflexia
Fontanella 1997	27 bladder biopsies, 62 TURBT, 21 TUIP or BNI, 12 TURP, 9 miscellaneous interventions	EMDA lignocaine 25 mA (lignocaine 4% with 150 ml water and 3 ml adrenaline so final solution 2% lignocaine and 0.01 mg/ml adrenaline in 300 ml) for 25 min	N/A	111/122 (91%) procedures recorded as minimal-no discomfort 5/122 (4%) intolerable pain 6/122 (5%) painful but tolerable
Jewett 1999	Prior to bladder biopsy, TURBT or TURP	EMDA lidocaine 100 ml 4% mixed with 100 ml sterile water and 2 ml epinephrine (1 mg/ml) for a final concentration of 1:100,000 (25 mA for 20 to 25 min)	Bladder biopsy without EMDA lidocaine	Significant reduction in pain with EMDA versus no anesthesia for biopsy, and higher patient satisfaction
Riedl 1998a	5 TURBT, 3 tumor coagulation, 3 bladder biopsies	EMDA lidocaine 1%-2.6% 15-23 mA for 15-20 min	N/A	83% had painless and tolerable transurethral procedures 1/11 had tolerable pain 1/11 required GA from intolerable pain
Rose 2005	Prior to bladder hydrodistension under local anesthesia	EMDA 30 mA 2% NaCl-free lidocaine hydrochloride, adrenaline 1.5 mg, dexamethasone 16 mg in 150 ml sterile water for 20-30 min followed by cystodistension	Bladder distension under GA	Median absolute difference in bladder capacity only 25 ml between GA and EMDA groups, median percent difference was 5%
Schurch 2004	Prior to intravesical injection of botulinum toxin A	EMDA lidocaine 25 mA for 20--25 min (75 ml lidocaine hydrochloride 4% with 75 ml sterile water and 1.5 ml 1/100,000 epinephrine so final solution of 150 ml lidocaine 2% with epinephrine 1/100,000)	Passive intravesical instillation 40 ml lidocaine 2%, retained in bladder for 20 min	Reduced pain score in EMDA group with a mean score of 0.5 versus mean score of 4 in intravesical group when botulinum toxin type A injections were given

EMDA: Electromotive drug administration, TURBT: Transurethral resection of bladder tumor, GA: General anesthesia, TUIP: Transurethral incision of the prostate, TURP: Transurethral resection of the prostate, BNI: Bladder nec