Effects of Topical Anesthetics on catheter-related bladder Discomfort in patients undergoing ureteroscopic litholapaxy: A Single-Center Randomized Controlled Study

Background Urinary catheterization is a routine procedure after ureteroscopy lithotripsy URSL , but it often causes catheter-related bladder discomfort (CRBD) and urethral pain, which aggravates patients' postoperative discomfort. This study finds out the effect of topical anesthesia on CRBD and urethra pain in patients undergoing ureteroscopy lithotripsy and urinary catheterization. Methods In this study, 330 patients undergoing ureteroscopy lithotripsy enrolled, with 160 cases in the control group and 170 cases in the experimental group. The experimental group divided into two subgroups based on the local anesthetic used: Tetracaine Hydrochloride Gel subgroup and Oxybuprocaine Gel subgroup. Postoperative assessments conducted using CRBD scores and urethra pain numerical rating scale (NRS) score. CRBD and urethra pain NRS scores measured at T0, T1, T2, T3, T4, T5, and T6. Results Compared to the control group, the use of local anesthetics significantly reduced both CRBD scores and urethra pain NRS scores in the experimental group, with the differences being statistically significant (P < 0.01). In male patients, patients who used local anesthetics markedly decreased CRBD scores and urethra pain NRS scores compared to those not receiving local anesthetics, showing statistical significance (P < 0.01), whereas no significant difference followed in female patients. No statistically significant differences found between Rigid ureteroscopy lithotripsy R-URSL and Flexible ureteroscopy lithotripsy F-URSL) regardless of the use of local anesthetics. Within the experimental group, the effects of different local anesthetics were similar, with comparable impacts on CRBD scores and urethra pain NRS scores, and no statistical differences noted. These findings suggest that local anesthetics are effective in reducing postoperative CRBD scores and urethra pain NRS scores, especially in male patients. Conclusion Topical anesthesia following ureteroscopy lithotripsy reduces CRBD scores and urethra pain NRS scores in patients undergoing urinary catheterization, especially in male patients.