Why This Feeling Is So Common
Ureteroscopy is one of the most common ways doctors remove kidney stones. A thin instrument goes up through the urethra (the tube that carries urine out of the body) and into the kidney or ureter (the tube connecting kidney to bladder). After the procedure, a urinary catheter is placed to help the bladder drain and heal.
But the catheter does not sit quietly. It can trigger what doctors call catheter-related bladder discomfort, or CRBD. It feels like a strong, relentless urge to urinate. Some patients also feel burning or stinging in the urethra itself. For millions of people who undergo this surgery each year, this discomfort is simply accepted as part of recovery.
The Old Approach Left a Gap
Until now, most post-surgery care focused on managing pain from the surgery, not specifically from the catheter. Doctors used general pain relievers, but these do not always reach the local tissue causing the irritation. Think of it like trying to quiet a fire alarm by muffling the speaker — the alarm keeps going off because the source of the problem is not addressed.
But here is the twist: applying a numbing agent directly to the area before catheter insertion could target the problem at its source.
Topical anesthetics (numbing gels) work by blocking pain signals at the nerve endings in the urethra and bladder neck. Think of it like temporarily turning off a doorbell at the door itself, rather than trying to ignore the ringing from another room. When the catheter goes in through a pre-numbed passage, the tissues are less likely to fire off pain and urgency signals.
Two gels were tested in this study: Tetracaine Hydrochloride Gel and Oxybuprocaine Gel. Both are already used in clinical settings for local numbing.
Researchers at a single center enrolled 330 patients undergoing ureteroscopy for kidney stones. Of those, 160 received standard care (no gel), while 170 received one of the two numbing gels before catheter placement. Pain and bladder discomfort were measured at seven time points after surgery using standard rating scales.
The results were clear. Patients who received the numbing gel reported significantly lower CRBD scores and urethral pain scores at every measurement point after surgery. The difference was large enough to be statistically significant — meaning it was very unlikely to be due to chance.
The effect was especially strong in male patients. Men who received the gel had meaningfully lower pain and discomfort than men who did not. In women, the difference was not statistically significant, likely because female urethral anatomy is shorter and differently shaped.
This does not mean the discomfort disappears entirely — but it could become much more manageable.
There was no significant difference between the two gels tested. Both reduced discomfort to a similar degree, suggesting that it is the category of treatment — not which specific product — that matters most.
Where This Fits in the Bigger Picture
Catheter-related discomfort after surgery is often undertreated because it is considered a minor side effect. But for patients, it can feel anything but minor. This research supports a simple, low-cost intervention that could make recovery more comfortable without adding significant complexity or risk to post-operative care.
If you are scheduled for ureteroscopy, ask your surgical team whether a topical anesthetic gel is part of their catheter placement protocol. This is not an experimental treatment — both gels used in the study are already in clinical use. However, the decision on whether to use them should come from your doctor based on your specific situation.
This was a single-center study involving patients at one hospital. The sample size was relatively modest, and the study did not follow patients beyond the immediate post-operative period. The results may not apply equally across different clinical settings or patient populations.
Larger, multi-center trials are needed to confirm these findings across diverse patient groups and hospital settings. Researchers will also need to explore whether specific gel formulations, dosages, or application timing make a meaningful difference. If the results hold up, this simple step could become a standard part of urological post-operative care worldwide.
