title: Management of Catheter-Related Bladder Discomfort in Patients Who Underwent Elective Surgery.
abstract: OBJECTIVE
  Despite the various treatment and prevention options for catheter-related bladder discomfort (CRBD), many uncertainties persist in clinical practice. To systematically review the literature on the management of CRBD in patients who underwent surgery.
  
  
  METHODS
  Eligible, randomized controlled trials were identified from electronic databases (Cochrane Central Register of Controlled Trials, Medline, and EMBASE) without language restrictions. Selection criteria, methodological rigor, and risk of bias were evaluated by two independent reviewers using Cochrane Collaboration's tools.
  
  
  RESULTS
  A total of 1441 patients from 14 articles published between 2005 and 2014 were included. Data heterogeneity precluded meta-analysis; therefore, data were synthesized narratively. Compared with nonurological surgery, CRBD is frequent and occurred immediately after urological surgery, especially after transurethral resection of the bladder tumor (TURBT). Data from included studies suggested that muscarinic antagonists, anesthetics, antiepileptics, and analgesics were associated with significant improvement in symptoms and reducing the incidence of CRBD, compared with placebo. Anticholinergic agents and antiepileptics (gabapentin and pregabalin) administered 1 hour before surgery reduced the incidence and severity of CRBD in the immediate postoperative period. Tramadol and ketamine are centrally acting opioid analgesics with antimuscarinic actions, which effectively prevent CRBD when administered intravenously. Paracetamol administered was also effective for the management of CRBD. Additionally, we perceived that TURBT is the surgical procedure that is the most refractory to treatment.
  
  
  CONCLUSIONS
  Muscarinic antagonists, anesthetics, antiepileptics, and paracetamol appear to achieve the greatest improvement in the clinical symptoms and a significant reduction in the incidence of CRBD compared with placebo. Although these studies observed a high incidence of intervention-related side effects, in general, patients tolerated these treatments well.
authors.affiliation: 1 Department of Urology, West China Hospital, Sichuan University , Chengdu, China .
authors.forename: Yunjin
authors.initials: Y
authors.lastname: Bai
authors.affiliation: 1 Department of Urology, West China Hospital, Sichuan University , Chengdu, China .
authors.forename: Xianding
authors.initials: X
authors.lastname: Wang
authors.affiliation: 2 Department of Anesthesiology, West China Hospital, Sichuan University , Chengdu, China .
authors.forename: Xiaoqiang
authors.initials: X
authors.lastname: Li
authors.affiliation: 1 Department of Urology, West China Hospital, Sichuan University , Chengdu, China .
authors.forename: Chunxiao
authors.initials: C
authors.lastname: Pu
authors.affiliation: 1 Department of Urology, West China Hospital, Sichuan University , Chengdu, China .
authors.forename: Haichao
authors.initials: H
authors.lastname: Yuan
authors.affiliation: 1 Department of Urology, West China Hospital, Sichuan University , Chengdu, China .
authors.forename: Yin
authors.initials: Y
authors.lastname: Tang
authors.affiliation: 1 Department of Urology, West China Hospital, Sichuan University , Chengdu, China .
authors.forename: Jinhong
authors.initials: J
authors.lastname: Li
authors.affiliation: 1 Department of Urology, West China Hospital, Sichuan University , Chengdu, China .
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wei
authors.affiliation: 1 Department of Urology, West China Hospital, Sichuan University , Chengdu, China .
authors.forename: Ping
authors.initials: P
authors.lastname: Han
mesh_terms: D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage; D006801:Humans; D008297:Male; D018727:Muscarinic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014546:Urinary Catheterization / Q000009:adverse effects*
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D018727:Muscarinic Antagonists