Impact of bladder spasm score combined with modified PDCA cycle management on the incidence of bladder spasm following transurethral thulium laser enucleation of the prostate

doi:10.3877/cma.j.issn.1674-3253.2026.03.009

Abstract

Abstract:

Objective

To investigate the impact of bladder spasm score combined with a modified PDCA cycle nursing management model on the incidence of bladder spasm in patients undergoing transurethral thulium laser enucleation of the prostate (ThuLEP).

Methods

The data of patients admitted to the Department of Urology, Shanghai East Hospital, from January 2022 to November 2024 for ThuLEP were retrospectively analyzed. Among them, 246 patients treated between January 2022 and June 2023 were assigned to the control group and received routine nursing care. A total of 278 patients treated from July 2023 to November 2024 were assigned to the observation group and underwent nursing management integrating a self-designed bladder spasm score with a modified PDCA cycle. Comparisons were made between the two groups regarding bladder spasm scores, incidence of bladder spasm, pain scores, postoperative bladder irrigation duration, the decrease in hemoglobin on the first day after the operation, postoperative hospital stay, analgesic usage rate, quality of life (QOL), anxiety scores, and nursing satisfaction.

Results

All 524 enrolled patients successfully completed the surgery without requiring reoperation. In the control group, 69 cases (28.05%) developed postoperative bladder spasm, whereas 31 cases (11.15%) were observed in the observation group, demonstrating a statistically significant difference (P<0.05). The postoperative visual analogue scale (VAS) scores were significantly lower in the observation group [1(1, 2)] compared to the control group [3(1, 5)] (P=0.016). No significant differences were observed in postoperative bladder irrigation duration or hospital stay between the two groups (P>0.05). The bladder spasm score was significantly reduced in the observation group (5.3±2.4) versus the control group (9.5±2.7) (P=0.016). Statistically significant improvements were also noted in quality of life (QOL) scores, anxiety scores, and nursing satisfaction (P=0.006, 0.002, and 0.026, respectively).

Conclusion

The integrated bladder spasm score and modified PDCA cycle nursing management model effectively reduces the incidence of bladder spasm following thulium laser enucleation of the prostate, enhances patients' disease awareness, alleviates anxiety, and improves nursing satisfaction.

Key words: Thulium laser, Enucleation of the prostate, Bladder spasm, Bladder spasm score, PDCA cycle management

Jing Ye, Jinyu Zhang, Yueting Wan, Na Li, Shiwei Zhuang. Impact of bladder spasm score combined with modified PDCA cycle management on the incidence of bladder spasm following transurethral thulium laser enucleation of the prostate[J]. Chinese Journal of Endourology(Electronic Edition), 2026, 20(03): 291-296.

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References 25

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组别	例数	年龄[岁，(±s)]	前列腺大小[mL，(±s)]	PSA[ng/mL，M(Q)]	手术时间[min，M(Q)]	术后疼痛视觉评分M(Q)	膀胱冲洗时间[h，M(Q)]	术后出院时间[d，M(Q)]
对照组	246	71.4±8.5	68.4±12.2	3.9 (1.5，7.2)	95 (70，100)	3 (1，5)	24 (12，36)	4 (3，8)
观察组	278	70.5±10.2	64.3±15.6	3.6 (1.3，6.5)	100 (90，110)	1 (1，2)	24 (12，36)	3 (2，5)
统计值		t=0.324	t=0.976	Z=0.776	Z=-1.486	Z=2.420	Z=0.023	Z=0.442
P值		0.746	0.328	0.438	0.138	0.016	0.982	0.657
组别	膀胱痉挛评分(±s)	膀胱痉挛发情况[例(%)]	血红蛋白下降[g/L，(±s)]	术后止痛药物使用情况[例(%)]	生活质量评分[分，M(Q)]	焦虑评分(±s)	对护理满意情况[例(%)]
对照组	9.5±2.7	69 (28.05)	10.56±5.78	56 (22.76)	3(2，6)	42.5±21.3	218 (88.61)
观察组	5.3±2.4	31 (11.15)	11.38±6.26	38 (13.67)	2(1，4)	30.5±15.3	275 (98.90)
统计值	t=2.405	χ² =24.130	t=0.580	χ² =4.360	Z=2.748	t=3.110	χ² =4.890
P值	0.016	<0.001	0.564	0.038	0.006	0.002	0.026

组别	例数	年龄[岁，(±s)]	前列腺大小[mL，(±s)]	PSA[ng/mL，M(Q)]	手术时间[min，M(Q)]	术后疼痛视觉评分M(Q)	膀胱冲洗时间[h，M(Q)]	术后出院时间[d，M(Q)]
对照组	246	71.4±8.5	68.4±12.2	3.9 (1.5，7.2)	95 (70，100)	3 (1，5)	24 (12，36)	4 (3，8)
观察组	278	70.5±10.2	64.3±15.6	3.6 (1.3，6.5)	100 (90，110)	1 (1，2)	24 (12，36)	3 (2，5)
统计值		t=0.324	t=0.976	Z=0.776	Z=-1.486	Z=2.420	Z=0.023	Z=0.442
P值		0.746	0.328	0.438	0.138	0.016	0.982	0.657
组别	膀胱痉挛评分(±s)	膀胱痉挛发情况[例(%)]	血红蛋白下降[g/L，(±s)]	术后止痛药物使用情况[例(%)]	生活质量评分[分，M(Q)]	焦虑评分(±s)	对护理满意情况[例(%)]
对照组	9.5±2.7	69 (28.05)	10.56±5.78	56 (22.76)	3(2，6)	42.5±21.3	218 (88.61)
观察组	5.3±2.4	31 (11.15)	11.38±6.26	38 (13.67)	2(1，4)	30.5±15.3	275 (98.90)
统计值	t=2.405	χ² =24.130	t=0.580	χ² =4.360	Z=2.748	t=3.110	χ² =4.890
P值	0.016	<0.001	0.564	0.038	0.006	0.002	0.026

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