Preventing Catheter Related Bladder Discomfort (CRBD) in male patients undergoing Lower Urinary tract surgery with Bilateral Pudendal Nerve Block:A Randomized Controlled Trial
Keywords:Pudendal nerve block, CRBD, TURP, TURBT
Objective: To compare the frequency and severity of post-operative CRBD in patients undergoing TURP and TURBT with spinal anaesthesia with pudendal nerve block against spinal anaesthesia alone.
Study Design: A randomized controlled trial (Clinical trials.gov: NCT05022160)
Place and Duration of Study: Armed Forces Institute of Urology (AFIU), Rawalpindi Pakistan, from Aug to Nov, 2021.
Methodology: The trial comprised 250 patients scheduled to have a transurethral resection of the prostate (TURP) or a transurethral resection of a bladder tumour (TURBT) under spinal anaesthesia. They were split into two groups: study (group-P) and control (group-C). After surgery, the patients in the study-group were given a bilateral pudendal nerve block. At 3, 8, 12, and 24 hours following surgery, the frequency and severity of catheter-related bladder discomfort (CRBD) were documented.
Results: CRBD frequencies were significantly lower in pudendal group at 3 hours 42 (33.8%) vs 72 (58.5%), p <0.001), 8 hours 81 (65.3%) vs 111 (90.2%), p<0.001 and 12 hours 53 (42.7%) vs 73 (59.3%), p=0.009 after the surgery. The postoperative pain score in pudendal group was lower at 3 hours (p<0.001), 8 hours (p <0.001), and 12 hours (p=0.02) but there was no statistically significant difference between the two groups at 24 hours (p=0.06).
Conclusion: When used in conjunction with spinal anaesthesia, a pudendal nerve block reduces the frequency and severity of catheter-related bladder discomfort for up to 12 hours after surgery.