Comparative effectiveness of interventions for managing urological postoperative catheter-related bladder discomfort: a systematic review and network meta-analysis

Abstract Background Catheter-related bladder discomfort (CRBD) is a common postoperative bladder pain syndrome. Many drugs and interventions for managing CRBD have been studied, but their comparative effectiveness remains controversial. We made a study to assess the comparative effectiveness of interventions included Ketorolac, Lidocaine, Chlorpheniramine, Gabapentin, Magnesium, Nefopam, Oxycodone, Parecoxib, Solifenacin, Tolterodine, Bupivancaine, Dexmedetomidine, Hyoscine N-butyl bromide Ketamine, Penile nerve block on urological postoperative CRBD. Methods We performed a network meta-analysis (NMA) via ADDIS software included 18 studies with 1816 patients and assessed the risk of bias by Cochrane Collaboration tool. The incidence of moderate to severe CRBD at 0, 1, and 6 h after surgery and the incidence severe CRBD at 1h after surgery were compared. We ranked these interventions according outcomes. Result The number of best rank is 0.48(Nefopam) and 0.22(Nefopam) in the incidence of moderate to severe CRBD at 1h and incidence severe CRBD at 1h. More than half of studies at unclear or high risk of bias. Conclusion Nefopam ranked first in reducing incidence and severity of CRBD but with heterogeneity in study settings and outcome measures.