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
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.
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).
Exclusion Criteria:
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
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.
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.
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
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.
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)
Plan to share: No
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Mersin University