CClinicalTrials.gg
Not yet recruitingNCT07843602Updated Sep 28, 2026

Effect of Cyclic Sighing Breathing Exercise on CRBD, Pain, and Sleep Quality in Patients Undergoing TUR

An interventional study of Cyclic Sighing Breathing Exercise in Transurethral Resection of Bladder Tumor, Transurethral Resection of the Prostate (TURP) and Transurethral Resection of the Bladder, sponsored by Mersin University. Not yet recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-28.

Sponsored by Mersin University · Not applicable, Interventional, and Other

Phase
Not applicable
Study type
Interventional
Enrollment
76
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Transurethral resection (TUR) is a common minimally invasive surgical procedure for lower urinary tract diseases. However, postoperative urinary catheterization often causes catheter-related bladder discomfort (CRBD) and pain due to bladder spasms, which negatively impact recovery and sleep quality. Pharmacological agents used to alleviate CRBD and pain may cause adverse side effects. This study aims to evaluate the effects of cyclic sighing breathing exercises on CRBD severity, pain intensity, and sleep quality in patients undergoing TUR.

Read the detailed description

This prospective, two-arm, parallel-group, randomized controlled clinical trial will be conducted in the Urology Ward of Hatay İskenderun State Hospital. A total of 76 patients scheduled for TUR (TUR-P or TUR-B/TUR-M) will be allocated into either the intervention group (n=38) or the control group (n=38) using block randomization with sealed opaque envelopes. The intervention group will receive pre-operative training on cyclic sighing breathing exercise. Postoperatively, participants in this group will perform cyclic sighing (two deep nasal inhalations followed by prolonged oral exhalation) for 5 minutes at the 1st, 2nd, 6th, 12th, and 24th postoperative hours under researcher supervision (completed before 22:00 to avoid nocturnal sleep disruption). The control group will receive routine standard postoperative nursing care. CRBD severity and pain intensity will be assessed at the 1st, 2nd, 6th, 12th, and 24th postoperative hours. Sleep quality will be evaluated on the morning of the first postoperative day (after awakening).

02

Conditions studied

  • Transurethral Resection of Bladder Tumor
  • Transurethral Resection of the Prostate (TURP)
  • Transurethral Resection of the Bladder

Keywords

  • Sleep quality
  • Transurethral resection
  • Breathing exercises
  • pain
  • Urinary catheterization
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Aged 18 years or older
  • Undergoing Transurethral Resection of the Prostate (TUR-P) or Transurethral Resection of Bladder Tumor (TUR-M/TUR-BT)
  • Having an indwelling urethral catheter placed postoperatively
  • Fully conscious, oriented, and cooperative
  • Able to speak and understand Turkish
  • Volunteering to participate and providing written informed consent

Exclusion criteria

Exclusion Criteria:

  • American Society of Anesthesiologists (ASA) physical status score of IV or higher
  • Presence of any medical condition or physical impairment that prevents performing breathing exercises
  • Diagnosed history of sleep apnea
  • Regular use of sedative, hypnotic, or sleep-inducing medications
  • Neurological or psychiatric disorders severely impeding hearing, vision, or verbal communication
  • Refusal to participate in the study
04

Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
76 participants (estimated)

Study arms

  • Experimental
    Experimental group

    Patients in this arm will receive preoperative training on the cyclic sighing breathing exercise technique from the researcher upon clinical admission. Following transurethral resection (TUR) surgery, participants will perform cyclic sighing breathing exercises under researcher supervision at the 1st, 2nd, 6th, 12th, and 24th postoperative hours. Each exercise session will last for 5 minutes and consists of taking a deep breath in through the nose, followed immediately by a second short breath to fully inflate the lungs, and then exhaling slowly and fully through the mouth. In addition to the breathing intervention, patients will receive standard postoperative clinical nursing care.

    Other: Cyclic Sighing Breathing Exercise

  • No intervention
    Control Group

    Patients in this arm will receive routine standard postoperative nursing care and physician-prescribed clinical treatments (such as standard continuous bladder irrigation and routine analgesic or antispasmodic medications as needed) without any structured breathing exercise education or intervention.

Interventions

  • OtherCyclic Sighing Breathing Exercise

    The cyclic sighing intervention consists of structured breathing sessions taught preoperatively and supervised postoperatively. The patient assumes a comfortable supine or semi-Fowler position in bed. The exercise involves taking a slow, deep inhalation through the nose, immediately followed by a second short nasal inhalation to achieve maximum lung expansion, and then slowly and fully exhaling through the mouth, ensuring that exhalation lasts longer than inhalation. Patients perform this cycle continuously for 5 minutes at the 1st, 2nd, 6th, 12th, and 24th postoperative hours under researcher supervision. To protect nocturnal sleep patterns, sessions scheduled after 22:00 will be completed by 22:00.

05

What researchers measure

Primary outcomes

  1. Catheter-Related Bladder Discomfort (CRBD) Severity Score

    Catheter-related bladder discomfort severity is assessed using the 4-point rating scale developed by Agarwal et al. The scale classifies discomfort as: 0 = none; 1 = mild (reported by the patient only upon direct questioning); 2 = moderate (reported spontaneously by the patient without being asked, but not accompanied by behavioral responses); and 3 = severe (reported spontaneously and accompanied by behavioral manifestations such as vocal complaints, restless limb movements, or attempting to pull out the urinary catheter). Higher scores indicate greater severity of bladder discomfort.

    Time frame: Measured at the 1st, 2nd, 6th, 12th, and 24th postoperative hours

Secondary outcomes

  1. Postoperative Pain Intensity Score

    Postoperative pain is assessed using the Numeric Rating Scale (NRS). Patients rate their perceived pain intensity on an 11-point scale from 0 to 10, where 0 represents "no pain" and 10 represents the "worst possible pain". Higher scores reflect higher pain intensity. In addition, total analgesic consumption and medication types will be recorded during the first 24 postoperative hours.

    Time frame: Measured at the 1st, 2nd, 6th, 12th, and 24th postoperative hours.

  2. Postoperative Sleep Quality Score

    Sleep quality is assessed using the Richard-Campbell Sleep Questionnaire (RCSQ). The instrument evaluates 5 domains (sleep depth, sleep latency, awakenings, time spent awake, and overall sleep quality) using a 0-100 mm Visual Analog Scale (VAS). Total scores range from 0 to 100, with higher scores indicating superior sleep quality (scores \>50 denote good sleep quality).

    Time frame: On the morning of postoperative day 1 (upon awakening)

06

Study locations

1 site
  • Hatay Iskenderun State Hospital
    Hatay, 31000, Turkey (Türkiye)
    • Hasan Şeren · Contact · hasanseren94@gmail.com · +90326 615 37 50
    • Hasan Şeren · Principal investigator
    • Gülay Altun Uğraş · Principal investigator
07

References and documents

Publications

  • Li C, Liu Z, Yang F. Predictors of catheter-related bladder discomfort after urological surgery. J Huazhong Univ Sci Technolog Med Sci. 2014 Aug;34(4):559-562. doi: 10.1007/s11596-014-1315-z. Epub 2014 Aug 19. PubMed 25135727 ↗
  • Markopoulos T, Katsimperis S, Lazarou L, Tzelves L, Mitsogiannis I, Papatsoris A, Skolarikos A, Varkarakis I. Catheter-Related Bladder Discomfort: Insights Into Pathophysiology, Clinical Impact, and Management. Cureus. 2025 Mar 27;17(3):e81322. doi: 10.7759/cureus.81322. eCollection 2025 Mar. PubMed 40291191 ↗
  • Mitobe Y, Yoshioka T, Baba Y, Yamaguchi Y, Nakagawa K, Itou T, Kurahashi K. Predictors of Catheter-Related Bladder Discomfort After Surgery: A Literature Review. J Clin Med Res. 2023 Apr;15(4):208-215. doi: 10.14740/jocmr4873. Epub 2023 Apr 28. PubMed 37187710 ↗
  • Etezadi F, Sajedi Y, Khajavi MR, Moharari RS, Amirjamshidi A. Preemptive Effect of Intraurethral Instillation of Ketamine-lidocaine Gel on Postoperative Catheter-related Bladder Discomfort after Lumbar Spine Surgery. Asian J Neurosurg. 2018 Oct-Dec;13(4):1057-1060. doi: 10.4103/ajns.AJNS_314_17. PubMed 30459867 ↗
  • Ghorbani A, Hajizadeh F, Sheykhi MR, Mohammad Poor Asl A. The Effects of Deep-Breathing Exercises on Postoperative Sleep Duration and Quality in Patients Undergoing Coronary Artery Bypass Graft (CABG): a Randomized Clinical Trial. J Caring Sci. 2018 Dec 1;8(4):219-224. doi: 10.15171/jcs.2019.031. eCollection 2019 Dec. PubMed 31915624 ↗
  • Hu B, Li C, Pan M, Zhong M, Cao Y, Zhang N, Yuan H, Duan H. Strategies for the prevention of catheter-related bladder discomfort: A PRISMA-compliant systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2016 Sep;95(37):e4859. doi: 10.1097/MD.0000000000004859. PubMed 27631249 ↗
  • Agarwal A, Raza M, Singhal V, Dhiraaj S, Kapoor R, Srivastava A, Gupta D, Singh PK, Pandey CK, Singh U. The efficacy of tolterodine for prevention of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Anesth Analg. 2005 Oct;101(4):1065-1067. doi: 10.1213/01.ane.0000167775.46192.e9. PubMed 16192522 ↗
  • Balban MY, Neri E, Kogon MM, Weed L, Nouriani B, Jo B, Holl G, Zeitzer JM, Spiegel D, Huberman AD. Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Rep Med. 2023 Jan 17;4(1):100895. doi: 10.1016/j.xcrm.2022.100895. Epub 2023 Jan 10. PubMed 36630953 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT07843602
Lead sponsor
Mersin University
Responsible party
Hasan Şeren (MSc, RN, PhD Student, Mersin University) — Principal investigator
First posted
Sep 28, 2026
Start date
Oct 1, 2026 (estimated)
Primary completion
Feb 28, 2027 (estimated)
Completion
Oct 1, 2027 (estimated)
Last update
Sep 28, 2026

Study contacts

Hasan Şeren
Contact
hasanseren94@gmail.com
+903266153750 ext. 1237
Hasan Şeren
Contact
Gülay Altun Uğraş
study director · Mersin University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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