Interventions for the Management of Bladder Spasms in Adults with Indwelling Urinary Catheters: A Nursing Practice-Oriented Systematic Review.

OBJECTIVE

To critically synthesize evidence on pharmacological and non-pharmacological interventions relevant to nursing practice for the prevention and management of bladder spasms and catheter-related bladder discomfort in adults with indwelling urinary catheters.

METHODS

A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases including PubMed, CINAHL, MEDLINE, and Scopus were searched for English-language studies published from 2015 to 2025. Randomized controlled trials, quasi-experimental, and prospective studies involving adult patients with indwelling urinary catheters were included.

RESULTS

Ten studies met the inclusion criteria. Both pharmacological and non-pharmacological interventions were effective in reducing bladder spasms and catheter-related bladder discomfort. Non-pharmacological, nursing-led interventions-such as catheter balloon volume adjustment, neuromodulatory techniques, evidence-based targeted nursing care, structured nursing management models, and Traditional Chinese Medicine-based nursing approaches-demonstrated consistent reductions in symptom severity and improvements in patient comfort. Pharmacological therapies, including vitamin C, solifenacin, and ketamine, were primarily effective for short-term symptom relief. Overall, four studies were assessed as having low risk of bias, five as moderate risk, and one as high risk.

CONCLUSION

Nursing-led, non-pharmacological interventions play a central role in managing bladder spasms in patients with indwelling urinary catheters and should be prioritized in clinical practice. Further high-quality studies with standardized outcome measures are required to strengthen the evidence base.