Bladder Spasm Discomfort After Transurethral Surgery: A Prospective Observational Study of Preoperative, Intraoperative, and Postoperative Predictive Factors

Catheter-related bladder discomfort (CRBD) is a common and distressing complication following transurethral urologic procedures such as transurethral resection of the prostate (TURP) and transurethral resection of bladder tumors (TURBT). This prospective observational study investigated the role of preoperative, intraoperative, and postoperative factors in predicting the severity of postoperative bladder spasms. A total of 122 patients were enrolled, and bladder discomfort was assessed using the Visual Analogue Scale (VAS) during their postoperative hospital stay. Most clinical and surgical variables, including anesthesia type, procedure type, catheter type, energy modality, and patient demographics, showed no significant association with bladder discomfort severity. However, catheter balloon volume emerged as a significant predictor, with patients receiving 40 mL balloon volumes reporting higher VAS scores compared to those with smaller volumes (p = 0.003). Additionally, a weak but statistically significant correlation was found between hematocrit drop and VAS scores (rho = 0.18, p = 0.047), suggesting a possible link between intraoperative blood loss and postoperative discomfort. These findings highlight the potential for simple interventions, such as optimizing catheter balloon volume, to alleviate CRBD and enhance postoperative recovery.