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Randomized Controlled Trial
. 2024 Nov 1;41(11):821-830.
doi: 10.1097/EJA.0000000000002050. Epub 2024 Aug 13.

Transcutaneous electrical nerve stimulation and catheter-related bladder discomfort following transurethral resection of bladder tumour: A randomised controlled trial

Jun-Young Park  1 , Jihion Yu, Chan-Sik Kim, Ji-Won Baek, Taeho Mun, Young-Kug Kim
Affiliations
Randomized Controlled Trial

Transcutaneous electrical nerve stimulation and catheter-related bladder discomfort following transurethral resection of bladder tumour: A randomised controlled trial

Jun-Young Park et al. Eur J Anaesthesiol. .

Abstract

Background: Catheter-related bladder discomfort (CRBD) is problematic in patients with a urinary catheter. Transcutaneous electrical nerve stimulation (TENS) is a non-invasive analgesic modality used to relieve various types of pain.

Objectives: We evaluated the effect of TENS on CRBD after transurethral resection of bladder tumours (TURBT).

Design: A randomised controlled trial.

Setting: A large university tertiary hospital, from October 2022 to March 2023.

Patients: Patients requiring urinary catheterisation after TURBT.

Intervention: In this randomised controlled trial, patients were randomly allocated to the TENS ( n = 56) or control ( n = 56) groups. CRBD manifests as a burning sensation with an urge to void or discomfort in the suprapubic area. Moderate to severe CRBD was defined as patients self-reporting CRBD symptoms with or without behavioural response, including attempts to remove the urinary catheter, intense verbal reactions, and flailing limbs. TENS was performed from the end of surgery to 1 h postoperatively.

Main outcome measure: The primary endpoint was considered moderate to severe CRBD immediately postoperatively. Secondary endpoints included moderate to severe CRBD at 1, 2 and 6 h postoperatively. Additionally, postoperative pain, patient satisfaction, and TENS-related adverse effects were evaluated.

Results: Moderate to severe CRBD immediately postoperatively was significantly less frequent in the TENS group than in the control group: 10 (17.9%) vs. 34 (60.7%); P < 0.001; relative risk (95% CI) = 0.294 (0.161 to 0.536); absolute risk reduction = 0.43; number needed to treat = 2.3. Moderate to severe CRBD differed between the two groups at 1 h postoperatively: 1 (1.8%) vs. 16 (28.6%); P < 0.001; relative risk = 0.06 (95% CI 0.01 to 0.46); absolute risk reduction = 0.27; number needed to treat = 3.7. The TENS group exhibited a significantly lower score for postoperative pain at 1 h (1.8 ± 0.6 vs. 2.2 ± 0.4; P < 0.001, mean difference (95% CI) = 0.4 (0.2 to 0.6) and a higher score for patient satisfaction, 5.0 (4.0 to 6.0) vs. 3.0 (3.0 to 4.0); P < 0.001; median difference (95% CI) = 2.0 (1.0 to 2.0).

Conclusions: TENS reduced moderate to severe CRBD, decreased postoperative pain, and increased patient satisfaction after TURBT.

Clinical trial registry: Clinical Research Information Service (KCT0007450).

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References

    1. Babjuk M, Burger M, Capoun O, et al. European Association of Urology guidelines on nonmuscle-invasive bladder cancer (Ta, T1, and carcinoma in situ). Eur Urol 2022; 81:75–94.
    1. Agarwal A, Raza M, Singhal V, et al. The efficacy of tolterodine for prevention of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Anesth Analg 2005; 101:1065–1067.
    1. Park JY, Hong JH, Kim DH, et al. Magnesium and bladder discomfort after transurethral resection of bladder tumor: a randomized, double-blind, placebo-controlled study. Anesthesiology 2020; 133:64–77.
    1. Bai Y, Wang X, Li X, et al. Management of catheter-related bladder discomfort in patients who underwent elective surgery. J Endourol 2015; 29:640–649.
    1. Agarwal A, Dhiraaj S, Singhal V, et al. Comparison of efficacy of oxybutynin and tolterodine for prevention of catheter related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Br J Anaesth 2006; 96:377–380.

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