Recently, two specific studies were performed investigating the use of Lidocaine to decrease discomfort associated with urethral catheterization. The first published study supports the use of intraurethral Lidocaine for catheterization.(5) In this investigation, Lidocaine was repeatedly instilled into the urethra of ten 4- to 11-year-old patients for approximately 10 minutes prior to a scheduled cystogram. Patients in this study indicated significantly less pain with Lidocaine as a lubricant when compared to those who received sterile lubricant jelly. However, the placement of a catheter for cystogram requires the catheter to be in place for the duration of the procedure (10 to 15 minutes); whereas catheterization in the ED for urinalysis and urine culture requires catheter placement for a much shorter period of time. The second study, which compared Lidocaine to lubricant jelly used as a topical anesthetic prior to catheterization, found that preverbal patients experienced the same discomfort with or without Lidocaine when evaluated using Face-Legs-Activity-Cry-Consolability (FLACC) scoring.(11) Authors attempted to investigate Lidocaine topically placed at the urethral meatus to provide relief. Although the investigators did not achieve their goal of pain reduction using Lidocaine topically, they did find that the incidence of positive urine culture was similar in both the Lidocaine and placebo groups. Using the strengths of both previously published studies, our study will use Lidocaine both topically and instilled into the urethra.