Influence of Transcutaneous Tibial Nerve Stimulation on Postoperative Catheter-Related Bladder Discomfort in Urology: A Prospective, Randomized, Controlled Trial

Background: Male patients who undergo general anesthesia for urologic surgery are more prone to developing catheter-related bladder discomfort (CRBD). Transcutaneous tibial nerve stimulation (TTNS) is an established intervention for lower urinary tract dysfunction. This study aimed to evaluate the impact of TTNS on the occurrence of moderate to severe CRBD in male patients undergoing urological general anesthesia. Methods: The present study included 124 male urologic surgery patients from December 2023--June 2024 and were randomly divided into a test group and a control group via stratified block group randomization. The test group received 30 minutes of TTNS stimulation (200-μs pulses, 20/100 Hz alternating sparse-dense waves) in the recovery room after surgery, and the control group received 30 minutes of sham stimulation. The degree of CRBD and VAS scores at 0 h, 1 h, 2 h, and 6 h after tracheal extubation, the QoR-15 scores at 24 h postoperatively, the length of hospitalization, the medication remedy rates, and the occurrence of adverse reactions were compared between the two groups. Results: Compared with the control group, the present study demonstrated a statistically significant reduction in the incidence of moderate-to-severe CRBD at 0 hours after tracheal extubation in the TTNS group [ P = 0.002, CI=0.190–0.741, RR = 0.375]. The incidence of moderate to severe CRBD in the TTNS group was significantly lower than that in the C group at 1 and 2 hours after extubation ( P < 0.001, P = 0.002). Furthermore, the severity of CRBD at 0, 1, 2, and 6 hours after extubation was significantly different from that in the TTNS group ( P = 0.017, P < 0.001, P < 0.001, and P < 0.001, respectively). The VAS scores of patients in the TTNS group were notably lower than those in the C group at 0, 1, and 2 hours after tracheal extubation ( P = 0.009, P = 0.012, P = 0.013, P = 0.051, respectively). Compared with those in the C group, the QoR-15 scores at 24 hours postsurgery in the TTNS group were markedly greater ( P < 0.001). The incidence of postoperative nausea and medication rescue was lower in the TTNS group than in the C group ( P = 0.006, P < 0.001). The TTNS intervention was not associated with any adverse effects. Conclusion: TTNS effectively reduces moderate-to-severe CRBD incidence, enhances early postoperative analgesia, and improves recovery quality in male urologic surgery patients without significant safety concerns. Trial registration: This study was retrospectively registered and reviewed by a principal investigator (Xiangying Zheng) in the Chinese Clinical Trials Registry (registration number: ChiCTR2300078536) on 12/12/2023.