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; 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.