Buccal Acupuncture for Early Postoperative Catheter-Related Bladder Discomfort Following Ureteroscopic Lithotripsy: A Randomized, Sham-Controlled Trial.

PURPOSE: To evaluate whether buccal acupuncture (BA), a minimally invasive facial acupuncture technique, reduces early postoperative catheter-related bladder discomfort (CRBD) after ureteroscopic lithotripsy (URSL).

PATIENTS AND

METHODS

In this single-center, participant- and assessor-blinded, sham-controlled randomized trial, 118 patients undergoing URSL were randomized 1:1 to the BA group (n = 59) or sham group (n = 59). Baseline CRBD was assessed at extubation, followed by a 30-min PACU intervention. The BA group received needle insertion through guide tubes at bilateral Lower Jiao, Lumbar, and Sacral points; the sham group received identical guide-tube contact without needle penetration. The primary endpoint was moderate-to-severe CRBD (score ≥ 2) at 1 h after extubation. Secondary endpoints included CRBD at 2, 6, and 24 h, visual analog scale (VAS) pain, rescue medication use, Quality of Recovery-15 (QoR-15) and Richards-Campbell Sleep Questionnaire (RCSQ) scores on POD 1 and 2, adverse events, and participant blinding.

RESULTS

Moderate-to-severe CRBD at 1 h occurred less frequently in the BA group than in the sham group (13.6% vs. 40.7%; RR 0.33, 95% CI 0.16-0.68; P = 0.002; NNT = 4, 95% CI 3-9). This difference persisted at 2 h (6.8% vs. 25.4%; P = 0.012; NNT = 6, 95% CI 4-18), but not at 6 or 24 h. Fewer BA-group patients required rescue medication. VAS pain and RCSQ scores were comparable between groups. QoR-15 scores on POD 1 were higher in the BA group, although the difference did not reach the minimal clinically important difference. Minor insertion-site bleeding was the only BA-related adverse event, and participant blinding remained acceptable.

CONCLUSION

BA reduced early postoperative moderate-to-severe CRBD and rescue medication use after URSL. BA may be a safe, non-pharmacological adjunct for acute postoperative CRBD management.