Pudendal nerve block effect on post-operative urinary catheter-related bladder discomfort after robot-assisted radical prostatectomy Pudendal nerve block for catheter-related bladder discomfort

Abstract

Aim: In this study, we aimed to evaluate the effect of bilateral pudendal nerve block (PNB) on the prevention of catheter-related bladder discomfort (CRBD) in men undergoing robot-assisted radical prostatectomy (RARP). Material and Methods: A total of 83 patients who had previously undergone RARP and were catheterized by a 20Fr urethral catheter were evaluated. Between December 2017 and January 2020, retrospective data of 75 eligible patients were examined in two groups: as receiving bilateral pudendal nerve block (PNB) or not receiving as the control group. Under fluoroscopic view and digital rectal guidance, mixture a of 8 ml of Bupivacaine 0.5% and 40 mg of methylprednisolone (total 10 ml) was injected by a spinal needle at each side for PNB. Pain assessment, CRBD severity, and degree of discomfort experienced were evaluated using the self-reported questionnaires and the Wong-Baker FACES (WB-FACES) scale immediately after the procedure and at postoperative 1, 2, 6, and 12th hours. Results: No perioperative or postoperative complication related to the intervention was found in this retrospective data. Patients in the PNB group had statistically significantly lower CRBD values and lower WB-FACES scores compared to the control group (p<0.05) immediately after surgery and postoperatively. Furthermore, patients showed significant improvement, as assessed by the responses given to self-reported questionnaires, postoperatively. Discussion: Bilateral PNB performed immediately after completion of RARP significantly decreased CRBD. This intervention may help improve patient comfort, decrease analgesic use, and reduce hospital stays after RARP.