What question did this study set out to answer?

This study aims to evaluate the effectiveness of buccal acupuncture in reducing catheter-related bladder discomfort after ureteroscopic lithotripsy.

June 11, 2026Journal of Pain Research0 citationsOpen Access

Buccal Acupuncture for Early Postoperative Catheter-Related Bladder Discomfort Following Ureteroscopic Lithotripsy: A Randomized, Sham-Controlled Trial

HWHuizhen WuGuilin Medical University DWDong Wang81th Hospital of PLA CCChaojin ChenSun Yat-sen University

Key Points

This study aims to evaluate the effectiveness of buccal acupuncture in reducing catheter-related bladder discomfort after ureteroscopic lithotripsy.
Single-center, participant- and assessor-blinded, sham-controlled randomized trial
118 patients undergoing ureteroscopic lithotripsy were randomized to buccal acupuncture (59) or sham (59)
Primary endpoint was moderate-to-severe CRBD at 1 hour after extubation
Moderate-to-severe CRBD at 1 hour occurred in 13.6% of the BA group vs. 40.7% of sham group (RR 0.33, 95% CI 0.16–0.68; P = 0.002; NNT = 4)
At 2 hours, CRBD was 6.8% in the BA group vs. 25.4% in sham (P = 0.012; NNT = 6)
BA group patients required less rescue medication and had higher QoR-15 scores on POD 1, though not statistically significant

Abstract

Purpose: To evaluate whether buccal acupuncture (BA), a minimally invasive facial acupuncture technique, reduces early postoperative catheter-related bladder discomfort (CRBD) after ureteroscopic lithotripsy (URSL). Patients and Methods: In this single-center, participant- and assessor-blinded, sham-controlled randomized trial, 118 patients undergoing URSL were randomized 1:1 to the BA group (n = 59) or sham group (n = 59). Baseline CRBD was assessed at extubation, followed by a 30-min PACU intervention. The BA group received needle insertion through guide tubes at bilateral Lower Jiao, Lumbar, and Sacral points; the sham group received identical guide-tube contact without needle penetration. The primary endpoint was moderate-to-severe CRBD (score ≥ 2) at 1 h after extubation. Secondary endpoints included CRBD at 2, 6, and 24 h, visual analog scale (VAS) pain, rescue medication use, Quality of Recovery-15 (QoR-15) and Richards-Campbell Sleep Questionnaire (RCSQ) scores on POD 1 and 2, adverse events, and participant blinding. Results: Moderate-to-severe CRBD at 1 h occurred less frequently in the BA group than in the sham group (13.6% vs. 40.7%; RR 0.33, 95% CI 0.16– 0.68; P = 0.002; NNT = 4, 95% CI 3– 9). This difference persisted at 2 h (6.8% vs. 25.4%; P = 0.012; NNT = 6, 95% CI 4– 18), but not at 6 or 24 h. Fewer BA-group patients required rescue medication. VAS pain and RCSQ scores were comparable between groups. QoR-15 scores on POD 1 were higher in the BA group, although the difference did not reach the minimal clinically important difference. Minor insertion-site bleeding was the only BA-related adverse event, and participant blinding remained acceptable. Conclusion: BA reduced early postoperative moderate-to-severe CRBD and rescue medication use after URSL. BA may be a safe, non-pharmacological adjunct for acute postoperative CRBD management. Keywords: Buccal acupuncture, Catheter-related bladder discomfort, ureteroscopic lithotripsy, randomized controlled trial, Sham acupuncture, postoperative recovery

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