Journal of Anesthesia

, Volume 33, Issue 2, pp 348–348 | Cite as

Reply to the letter to the editor

  • Hyun-Kyu Yoon
  • Seokha Yoo
  • Won Ho KimEmail author
Letter to the Editor


Catheter-related bladder discomfort Network Meta-analysis 

To the Editor:

We are grateful to the authors for the thoughtful comments on our manuscript [1]. We agree with opinion that spinal anesthesia itself could decrease the incidence of catheter-related bladder discomfort (CRBD) postoperatively through residual spinal analgesic effect. Spinal anesthesia should be preferred to general anesthesia if possible. However, the incidence of CRBD at 24 h after surgery could be up to 84% [2] and the incidence at 72 h after surgery could still be as high as 48% [3] after transurethral resection of bladder tumor. This means that the residual analgesic effect of spinal anesthesia could not fully relieve the postoperative CRBD.

Network meta-analysis is a useful tool to facilitate estimation of the comparative efficacy and tolerability of multiple interventions even when they have not been investigated head-to-head in randomized trials. Compared to the standard pairwise meta-analysis, the precision of estimate could be increased. In addition, the limitation of our network meta-analysis of small number of studies and heterogeneity of studies should be acknowledged and more well-designed head-to-head randomized trials are required.


Compliance with Ethical Standards

Conflict of interest

No competing interest declared.


  1. 1.
    Hur M, Park SK, Yoon HK, Yoo S, Lee HC, Kim WH, Kim JT, Ku JH, Bahk JH. Comparative effectiveness of interventions for managing postoperative catheter-related bladder discomfort: a systematic review and network meta-analysis. J Anesth. 2019. Scholar
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    Bala I, Bharti N, Chaubey VK, Mandal AK. Efficacy of gabapentin for prevention of postoperative catheter-related bladder discomfort in patients undergoing transurethral resection of bladder tumor. Urology. 2012;79:853–7.CrossRefGoogle Scholar
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    Zhang Z, Cao Z, Xu C, Wang H, Zhang C, Pan A, Wei R, Peng S, Guo F, Wang L, Sun Y. Solifenacin is able to improve the irritative symptoms after transurethral resection of bladder tumors. Urology. 2014;84:117–21.CrossRefGoogle Scholar

Copyright information

© Japanese Society of Anesthesiologists 2019

Authors and Affiliations

  1. 1.Department of Anesthesiology and Pain Medicine, Seoul National University HospitalSeoul National University College of MedicineSeoulRepublic of Korea

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