Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
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Review

Volume 15, Number 4, April 2023, pages 208-215

Predictors of Catheter-Related Bladder Discomfort After Surgery: A Literature Review

Figure

Figure 1.
Figure 1. Flowchart of literature review.

Tables

Table 1. Rating Scale for Catether-Related Bladder Discomfort
 
No painNo report from the patient after interviewing
Grade 1 (mild pain)Rrevealed only by interviewing the patient
Grade 2 (moderate)A spontaneous complaint by the patient
Grade 3 (severe discomfort)Excitement, great frustration, and attempts to remove bladder catheter

 

Table 2. Studies on Predictors of CRBD
 
No.TitleYearMethodParticipantsIncidence of CRBDPredictors of CRBD (OR (95% CI), P value)
CI: confidence interval; CRBD: catether-related bladder discomfort; NRS: Numeric Rating Scale; OR: odds ratio; UCRP: urinary catheter-related pain.
APredictors of catheter-related bladder discomfort in the post-anaesthesia care unit [6]2011Prospective observational studyGroups: no CRBD group (none, mild): n = 120; CRBD group (moderate and severe): n = 44. Surgical operation: adult patients undergoing surgery under general anesthesia requiring intraoperative urinary catheterization. Observation period: 6 monthsNo CRBD group (mild: 20%). CRBD group (moderate and severe: 27%)Diameter of indwelling bladder catheter above 18 Fr: 2.2 (1.0 - 5.1), P = 0.06. Male: 3.2 (1.0 - 10.5), P < 0.06
BPredictors of catheter-related bladder discomfort after urological surgery [7]2014Prospective observational studyGroups: no CRBD group (none, mild), day 1: n = 65, day 3: n = 113; CRBD group (moderate/severe), day 1: n = 51, day 3: n = 3. Surgical operation: patients undergoing transurethral, laparoscopic, or open urological surgery; adult patients undergoing surgery under general or epidural anesthesia. Observation period: 3 monthsCRBD on day 1 (mild CRBD: 40.5%, moderate or severe CRBD: 44.0%). CRBD on day 3 (mild CRBD: 29.3%, moderate and severe CRBD: 2.6%)Open abdominal surgery: 3.074 (1.3 - 7.4), P < 0.05. Previous catheter insertion: 2.458 (1.1 - 5.9), P < 0.05
CPredictors of catheter-related bladder discomfort after gynaecological surgery [8]2020Prospective observational studyGroups: CRBD ≥ 1 point or higher group (mild 1 point = 93, moderate 2 points = 139, severe 3 points = 31): n = 263; CRBD ≥ 2 points group (moderate 2 points = 139, severe 3 points = 31): n = 170. Surgical operation: general anesthesia patients for gynecological surgery (all patients with 16 Fr indwelling bladder catheters). Observation period: 1 monthMild CRBD: 22.8%, moderate CRBD: 34.2%, severe CRBD: 7.6%50 years and older: 2.106 (1.2 - 3.8), P = 0.013. Uterus-related laparoscopic surgery: 1.863 (1.1 - 3.1), P = 0.019. Lack of additional analgesics: 0.408 (0.2 - 0.9), P = 0.032
DFactors predicting catheter-related bladder discomfort in surgical patients [4]2016Prospective observational studyGroups: CRBD 1 or less group (none 0 = 15, mild CRBD 1 = 74): n = 89; CRBD ≥ 2 points group (moderate 2 points = 51, severe 3 points = 20): n = 71. Surgical operation: patients who underwent surgery (excluding urologic patients). Observation period: 4 monthsModerate or severe: CRBD occurred in 44.3% of patients with indwelling bladder catheters.Under 50 years old: 4.79 (1.62 - 14.09), P = 0.005. Male gender: 7.07 (1.47 - 34.17), P = 0.015. Obstetrics and gynecology surgery: 11.07 (1.06 - 115.7), P = 0.045. Indwelling bladder catheter-related pain (UCRP: assessed by NRS) ≥ 4: 132.3 (24.6 - 690.4), P < 0.001
EPredictors of catheter-related bladder discomfort [9]2020Prospective observational studyGroups: no CRBD group (none, mild): n = 243; CRBD group (moderate and severe): n = 57. Surgical operation: adult patients undergoing surgery under general anesthesia requiring intraoperative urinary catheterization. Observation period: 6 months59% presented with symptoms of CRBD. More than 92% occurred on the first day of indwelling bladder catheter insertion.Diameter of indwelling bladder catheter above 18 Fr: 0.9 (0.08 - 1.1), P = 0.012. Lack of lubricant: 0.1 (0.05 - 1.1), P = 0.008. Laparotomy: 0.5 (0.1 - 1.9), P = 0.02. Under 50 years old: 0.4 (0.08 - 9), P = 0.006. Previous cesarean section: 0.2 (0.04 - 1.3), P = 0.032. Previous catheter insertion: 0.3 (0.06 - 2.1), P = 0.005

 

Table 3. Predictors of Catether-Related Bladder Discomfort
 
Patient factorsSurgical factorsAnesthetic factorsDevice and insertion technique factors
Male gender (A) (D); Age ≥ 50 years (C); Age < 50 years (D) (E); History of indwelling bladder catheters (B) (E); History of cesarean section (E)Abdominal open surgery (B) (E); Uterus-related laparoscopic surgery (C); Obstetrical and gynecological surgery (D)Lack of postoperative analgesics (C)A urinary catheter size of ≥ 18 Fr (A) (E); Lack of lubrication of a catheter (E)

 

Table 4. Overlap Between Each of the Studies on CRBD
 
No.TitlePatient factorsSurgical factorsAnesthetic factorsLack of lubrication of a catheter
Male genderAge ≥ 50 yearsAge < 50 yearsHistory of indwelling bladder cathetersHistory of cesarean sectionAbdominal open surgeryUterus-related laparoscopic surgeryObstetrical and gynecological surgeryLack of postoperative analgesicsA urinary catheter size of ≥ 18 FrLack of lubrication of a catheter
CRBD: catether-related bladder discomfort.
APredictors of catheter-related bladder discomfort in the post-anaesthesia care unit [6]••
BPredictors of catheter-related bladder discomfort after urological surgery [7]••
CPredictors of catheter-related bladder discomfort after gynaecological surgery [8]•••
DFactors predicting catheter-related bladder discomfort in surgical patients [4]•••
EPredictors of catheter-related bladder discomfort [9]••••••