Objective This study aimed to evaluate the effectiveness of the modified catheter in alleviating catheter-related pain. Methods This randomized controlled trial included 40 patients with similar characteristics scheduled for repeat transurethral resection of bladder tumor. At the end of surgery, a specially designed urethral catheter with multiple micropores enabling direct administration of local analgesic onto the urethral mucosa was inserted. In the treatment group, 0.5% ropivacaine was infused at 1 mL/hour (5 mg/hour), whereas the control group received normal saline. Visual Analogue Scale (VAS), Morphine Milligram Equivalents (MME), International Prostate Symptom Score (IPSS) and a 5-point Likert scale for willingness to reuse the catheter were assessed. Results During the first 6 postoperative hours, mean VAS increased by 1.80±1.06 in the treatment group and by 4.70±0.98 in the control group. The between-group mean difference was −2.90 (95% CI −3.55 to −2.25). From 6 to 24 hours, the change in VAS was −0.30±0.57 in the treatment group and −0.60±1.05 in the control group, with no meaningful between-group difference (mean difference, 0.30; 95% CI −0.24 to 0.84). At 24 hours, mean VAS was 1.75±1.12 in the treatment group and 4.25±0.97 in the control group. Cumulatively, VAS scores were lower in the treatment group compared with the control group (between-group mean difference −2.6, and 95% CI −3.22 to −1.97). The cumulative MME was significantly higher in the control group than in the treatment group (p<0.01), and MME was positively correlated with changes in VAS over 24 hours (R 2 for control and treatment groups were 0.33 and 0.31, respectively). Differences were also observed in the change of IPSS and its storage subscore between groups (p<0.01). The 5-Point Likert Scale for willingness to use the catheter was significantly higher in the treatment group than in the control group (p<0.01). Conclusion Our findings indicate that the novel catheter provides early pain control, reduces postoperative analgesic needs and lessens storage symptoms after catheter removal, improving patient satisfaction.
Lee et al. (Wed,) studied this question.