Evidence-based Prevention and Treatment of Postoperative Catheter-related Bladder Discomfort: A Comprehensive Review

Catheter-related bladder discomfort (CRBD) represents a highly prevalent postoperative complication following general anesthesia. Characterized by suprapubic pain, urinary urgency, and involuntary bladder contractions, CRBD significantly impairs patient recovery and satisfaction. This comprehensive review systematically examines the pathophysiological mechanisms, risk stratification, and evidence-based prevention and treatment strategies for CRBD. The underlying pathogenesis involves muscarinic receptor activation, inflammatory responses, and nociceptor sensitization. Established risk factors encompass patient characteristics, surgical variables, anesthetic factors, and device-related aspects. Multimodal interventions demonstrate superior efficacy, including pharmacological agents such as dexmedetomidine, gabapentin, nefopam, and antimuscarinics; regional anesthesia techniques including pudendal nerve block and sacral erector spinae plane block; and non-pharmacological approaches like transcutaneous electrical nerve stimulation and acupuncture. Technological innovations in catheter design and early removal protocols further enhance recovery outcomes. Future research priorities include external validation of machine learning prediction tools, large-scale comparative effectiveness trials of multimodal bundles, and development of smart catheter systems with integrated biosensing capabilities.