A Multicenter, Randomized, Single-Blind Trial Evaluating a Multi-Porous Urethral Catheter with Continuous Local Ropivacaine Infusion for the Reduction of Postoperative Catheter-Related Bladder Discomfort

Background/Objectives: Catheter-related bladder discomfort (CRBD) commonly occurs in patients undergoing urologic surgery and significantly affects patient comfort and recovery. We evaluated the efficacy and safety of continuous local ropivacaine infusion using a specialized multi-porous urethral catheter in reducing postoperative CRBD. Methods: This multicenter, prospective, randomized, single-blind trial enrolled 136 male patients undergoing short-term catheterization after urologic surgery. Participants were randomized into three groups-a control group receiving saline infusion, Group 1 receiving 0.5% ropivacaine at 1 mL/h, and Group 2 receiving 0.5% ropivacaine at 2 mL/h-for up to 48 h via a multi-porous urethral catheter. The primary outcome was the incidence of CRBD at 24 h postoperatively. Secondary outcomes included changes in urethral pain assessed by a visual analog scale (VAS), urinary symptom scores, complication rates, and patient-reported catheter inconvenience and reuse intention using Likert scales. Results: The incidence of CRBD was significantly lower in Group 1 (19.6%) and Group 2 (11.1%) compared to the control group (44.4%; p = 0.001), demonstrating a clear dose-response relationship. Changes in urethral pain scores (VAS) from baseline were significantly lower in the ropivacaine groups compared to the control (p = 0.023). Complication rates were similar among groups (control 13.3%, Group 1 6.5%, Group 2 15.6%; p = 0.378), although catheter leakage occurred more frequently in Group 2, without statistical significance (p = 0.122). Conclusions: Continuous local ropivacaine infusion using a multi-porous urethral catheter effectively reduces the incidence of postoperative CRBD without increasing side effects. This approach may improve patient comfort during perioperative catheter management.