Tetracaine hydrochloride gel delays and reduces catheter-related bladder discomfort after transurethral resection: a randomized controlled trial
- 1Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
- 2Department of Anesthesiology, Chongqing Hospital of Jiangsu Province Hospital, Chongqing, China
Abstract
Background: Catheter-related bladder discomfort (CRBD) results from involuntary bladder contractions triggered by both the indwelling urinary catheter and surgical trauma during transurethral resection. Systemic analgesics and anticholinergics are often used but carry risks of side effects. Topical anesthetics like tetracaine hydrochloride gel offer a potential targeted approach, but their efficacy in delaying and reducing CRBD remains unclear.
Methods: In this randomized, single-blind study, patients undergoing transurethral resection were allocated to the tetracaine gel group ( n = 65) or the lubricant control group ( n = 65). Before catheter insertion, three g of tetracaine gel or standard lubricant was evenly applied to the catheter surface. The primary outcome was the time to first-reported moderate-to-severe CRBD after tracheal extubation. Secondary outcomes included the incidence of new-onset moderate and severe CRBD at specified intervals, as well as the patient satisfaction, postoperative pain scores, analgesic requirements, and adverse events. The incidence of moderate-to-severe CRBD stratified by age and procedure type was also analyzed.
Results: The time to first-reported moderate-to-severe CRBD was significantly longer in the tetracaine gel group compared to the control group (30 [10.0–61.3] min vs. 5 [4.8–10.0] min, p < 0.001) among patients who developed this event. The incidence of new-onset moderate-to-severe CRBD was significantly lower in the tetracaine gel group within 30 min (15 [23.1%] vs. 43 [66.2%]; RR = 0.153, 95% CI [0.071–0.332]; p < 0.001) and over the total 24 hours assessment period (30 [46.2%] vs. 46 [70.8%]; RR = 0.354, 95% CI [0.172–0.730]; p = 0.004). A transient increase in incidence was noted in the tetracaine group between 30–120 min (11 [16.9%] vs. 2 [3.1%]; RR = 6.417, 95% CI [1.362–30.228]; p = 0.016). The non-significant interaction test indicates that the effect magnitude of tetracaine gel did not differ by age ( P for interaction = 0.392) or procedure type ( P for interaction = 0.883). Patient satisfaction at 6 hours was higher (6.7 ± 0.5 vs. 6.2 ± 0.8, p < 0.001), and postoperative pain scores were lower at all assessed time points. No significant differences were found in analgesic requirements, postoperative delirium, infections, or hospital stay.
Conclusions: Topical application of tetracaine gel to the urinary catheter effectively delays the onset and reduces the incidence of moderate-to-severe CRBD in the early postoperative period.
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BibTeX
@article{liu2026tetracaine,
title = {{Tetracaine hydrochloride gel delays and reduces catheter-related bladder discomfort after transurethral resection: a randomized controlled trial}},
author = {Yang Liu and Ling Li and Jingjin Li and Feng Feng and Haoran Wang and Zhenfeng Zhang and Zijian Zhao and Qingchun Sun},
journal = {PeerJ},
year = {2026},
month = nov,
doi = {10.7717/peerj.21891},
url = {https://peerj.com/articles/21891},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Tetracaine hydrochloride gel delays and reduces catheter-related bladder discomfort after transurethral resection: a randomized controlled trial
AU - Yang Liu
AU - Ling Li
AU - Jingjin Li
AU - Feng Feng
AU - Haoran Wang
AU - Zhenfeng Zhang
AU - Zijian Zhao
AU - Qingchun Sun
PY - 2026
DA - 2026/11/02
JO - PeerJ
DO - 10.7717/peerj.21891
UR - https://peerj.com/articles/21891
AB - Background: Catheter-related bladder discomfort (CRBD) results from involuntary bladder contractions triggered by both the indwelling urinary catheter and surgical trauma during transurethral resection. Systemic analgesics and anticholinergics are often used but carry risks of side effects. Topical anesthetics like tetracaine hydrochloride gel offer a potential targeted approach, but their efficacy in delaying and reducing CRBD remains unclear. Methods: In this randomized, single-blind study, patients undergoing transurethral resection were allocated to the tetracaine gel group ( n = 65) or the lubricant control group ( n = 65). Before catheter insertion, three g of tetracaine gel or standard lubricant was evenly applied to the catheter surface. The primary outcome was the time to first-reported moderate-to-severe CRBD after tracheal extubation. Secondary outcomes included the incidence of new-onset moderate and severe CRBD at specified intervals, as well as the patient satisfaction, postoperative pain scores, analgesic requirements, and adverse events. The incidence of moderate-to-severe CRBD stratified by age and procedure type was also analyzed. Results: The time to first-reported moderate-to-severe CRBD was significantly longer in the tetracaine gel group compared to the control group (30 [10.0–61.3] min vs. 5 [4.8–10.0] min, p < 0.001) among patients who developed this event. The incidence of new-onset moderate-to-severe CRBD was significantly lower in the tetracaine gel group within 30 min (15 [23.1%] vs. 43 [66.2%]; RR = 0.153, 95% CI [0.071–0.332]; p < 0.001) and over the total 24 hours assessment period (30 [46.2%] vs. 46 [70.8%]; RR = 0.354, 95% CI [0.172–0.730]; p = 0.004). A transient increase in incidence was noted in the tetracaine group between 30–120 min (11 [16.9%] vs. 2 [3.1%]; RR = 6.417, 95% CI [1.362–30.228]; p = 0.016). The non-significant interaction test indicates that the effect magnitude of tetracaine gel did not differ by age ( P for interaction = 0.392) or procedure type ( P for interaction = 0.883). Patient satisfaction at 6 hours was higher (6.7 ± 0.5 vs. 6.2 ± 0.8, p < 0.001), and postoperative pain scores were lower at all assessed time points. No significant differences were found in analgesic requirements, postoperative delirium, infections, or hospital stay. Conclusions: Topical application of tetracaine gel to the urinary catheter effectively delays the onset and reduces the incidence of moderate-to-severe CRBD in the early postoperative period.
SN - 2167-8359
ER -