A PROSPECTIVE randomised controlled trial suggests that transcutaneous tibial nerve stimulation (TTNS) significantly reduces catheter-related bladder discomfort (CRBD) and improves early recovery in male patients after urologic surgery under general anaesthesia.
CRBD is a common and distressing complication following urologic procedures, particularly in men, and is associated with agitation, pain, nausea, and delayed recovery. TTNS is a non-invasive neuromodulation technique already used in the management of lower urinary tract dysfunction, but evidence for its perioperative use has been limited.
The study enrolled 124 male patients scheduled for urologic surgery between December 2023 and June 2024. Participants were randomly assigned to receive either 30 minutes of active TTNS or sham stimulation in the post-anaesthesia care unit. The TTNS protocol used 200-μs electrical pulses with alternating sparse–dense frequencies of 20/100 Hz. Outcomes assessed included the incidence and severity of CRBD, pain scores using a visual analogue scale (VAS), quality of recovery, rescue medication use, length of hospital stay, and adverse events.
Nerve Stimulation Reduces Catheter-Related Bladder Discomfort
The researchers found that TTNS significantly reduced the incidence of moderate-to-severe CRBD immediately after tracheal extubation, with benefits persisting at 1 and 2 hours postoperatively. Across all assessed time points up to 6 hours after surgery, patients in the TTNS group experienced less severe bladder discomfort compared with controls. Early postoperative pain scores were also significantly lower in the TTNS group at 0, 1, and 2 hours following extubation.
Importantly, TTNS was associated with broader recovery benefits. Patients receiving active stimulation had significantly higher Quality of Recovery-15 (QoR-15) scores at 24 hours after surgery, indicating better overall postoperative recovery. In addition, the incidence of postoperative nausea and the need for rescue medication were lower in the TTNS group.
No TTNS-related adverse effects were reported, suggesting that the intervention is safe and well tolerated. Length of hospital stay did not differ significantly between groups.
Potential for TTNS as a Perioperative Care Strategy
The authors conclude that TTNS is an effective, safe, and non-invasive strategy for reducing postoperative CRBD, improving early analgesia, and enhancing recovery quality in male patients undergoing urologic surgery. They suggest that TTNS could be a valuable adjunct to perioperative care in urology, although further studies are needed to confirm its role across different patient populations and surgical settings.
Reference
Zheng X et al. Influence of transcutaneous tibial nerve stimulation on postoperative catheter-related bladder discomfort in urology: a prospective randomized controlled trial. Sci Rep. 2025;doi: 10.1038/s41598-025-32254-w
