How to ease catheter discomfort after a TURBT

Following a transurethral resection of a bladder tumor (TURBT), you may go home with a urinary catheter, and with it, may come some unexpected discomfort. This is a common part of recovery and there are strategies to help you manage catheter-related bladder discomfort (CRBD). Understanding why it happens and how to find relief can make a meaningful difference in how you feel day to day.

What is a TURBT?

A TURBT is a common procedure used to diagnose and treat bladder cancer, especially in its early stages. During the procedure, a surgeon inserts a thin instrument through the urethra (no external incision) to remove abnormal tissue or tumors from the bladder.

After surgery, a urinary catheter is sometimes placed temporarily to drain urine, help the bladder heal, and prevent clots. While necessary, the catheter can sometimes lead to discomfort.

What is catheter-related bladder discomfort (CRBD)?

CRBD is very common. Some studies estimate it affects up to 90% of patients with a catheter. It’s often described as:

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• A burning or stinging sensation
• A strong urge to urinate, even though a catheter is in place
• Discomfort in the lower abdomen or urethra

It’s important to note that CRBD is different from urinary catheter–related pain (UCRP). UCRP typically refers to pain or bladder spasms caused by irritation of the bladder wall, while CRBD is characterized by an uncomfortable urge to urinate despite the presence of a catheter.

Why does this discomfort happen?

There are a few key reasons:

1. Bladder irritation from the catheter: The catheter sits inside the bladder, which can irritate the lining and trigger discomfort.
2. Involuntary bladder cramps: The presence of a catheter can activate certain receptors in the bladder, leading to involuntary contractions (spasms) that create urgency and pain.
3. Post-surgical inflammation: After a TURBT, the bladder is already sensitive from tumor removal, making it more reactive to the catheter.
4. Constipation: Constipation can place pressure on the drainage lumen and affect how well your catheter drains. Studies have also shown that chronic constipation may also trigger bladder spasms. 
5. Continuous bladder irrigation: Some patients require flushing of the bladder after surgery, which can further increase irritation.

Ways to manage CRBD

Adjusting the catheter balloon size may be a simple yet effective way to reduce CRBD. If you’re still experiencing discomfort, your doctor may prescribe medications to reduce bladder spasms and pain, including drugs that help ease the urgency and frequency of urination, pain relievers, or injections that help manage overactivity. Some therapies have side effects, including drowsiness, fatigue, and nausea, so be sure to discuss them with your care team.

Potential new options for CRBD

New research suggests that non-invasive options like transcutaneous electrical nerve stimulation (TENS) may help reduce discomfort and improve satisfaction after TURBT, though these are typically used in clinical settings.

There’s also emerging data on intravenous (IV) acetaminophen for managing CRBD, but more research is needed for its specific use in TURBT recovery.

Simple strategies you can try at home

While medications help, small daily adjustments can also improve comfort:

• Stay hydrated: Drinking enough fluids helps dilute urine and reduce irritation.
• Avoid constipation: Eat a fiber-rich diet.
• Secure the catheter properly: Make sure the tubing isn’t pulling or tugging, which can worsen discomfort.
• Follow catheter care instructions closely: Keeping the area clean helps prevent infection and irritation.

When should you call your doctor?

While some discomfort is expected, there are certain symptoms that shouldn’t be ignored. Reach out to your care team if you experience:

• Severe or worsening pain
• Fever or chills
• Cloudy, foul-smelling urine
• Blood or blood clots
• No urine draining into the bag
• The catheter falls out or stops working
• Leakage of the catheter

If something doesn’t feel right, trust your instincts and check in with your care team.

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