Non-pharmacological Interventions for Postoperative Pain Management after Benign Prostatic Hyperplasia Surgery: A Systematic Review

Dwie Andrie Setyawan; Desiyani Nani

doi:10.26714/mki.9.2.2026.205-215

Non-pharmacological Interventions for Postoperative Pain Management after Benign Prostatic Hyperplasia Surgery: A Systematic Review

Dwie Andrie Setyawan^(1*), Desiyani Nani⁽²⁾

(1) Jendral Soedirman University
(2) Departmen of Nursing , Faculty of Health Science,Jenderal Soedirman University
(*) Corresponding Author

Abstract

Benign prostatic hyperplasia (BPH) affects aging men. Transurethral resection of the prostate (TURP) represents the standard surgical management for moderate to severe conditions. Postoperative pain remains a significant clinical problem. Conventional analgesic management demonstrates adverse effects. Variable patient responses remain evident. Non-pharmacological strategies require evaluation. This systematic review evaluates the effectiveness of non-pharmacological nursing interventions in postoperative pain management following BPH surgery. A systematic search was conducted in PubMed, Scopus, Web of Science, CINAHL, and Cochrane CENTRAL. The publication period is from January 2017 to December 2024. Inclusion criteria comprised randomized controlled trials, quasi-experimental studies, adult patients undergoing BPH surgery, non-pharmacological interventions, and pain outcomes using validated instruments. PRISMA 2020 guidelines guided study selection. Joanna Briggs Institute appraisal tools assessed methodological quality. Narrative synthesis was applied due to heterogeneity. A total of 1,086 records were identified. Ten studies met inclusion criteria. Seven randomized controlled trials. Three quasi-experimental studies. Interventions included relaxation techniques, transcutaneous electrical acupoint stimulation, acupuncture, pranic healing, enhanced recovery after surgery protocols, and integrative approaches. Relaxation techniques reduced pain intensity (p < 0.001). Transcutaneous electrical acupoint stimulation decreased catheter-related bladder discomfort and reduced analgesic consumption. Acupuncture demonstrated sustained improvement in chronic pelvic pain (p < 0.001). Enhanced recovery after surgery protocols reduced catheterization duration and decreased early postoperative pain. Evidence quality ranged from moderate to high. Non-pharmacological nursing interventions demonstrate effectiveness in postoperative pain reduction. Improved recovery outcomes observed. Further multicenter trials required. The development of standardized clinical guidelines is recommended.

Keywords

Benign prostatic hyperplasia; postoperative pain; non-pharmacological interventions; systematic review; transurethral resection of the prostate

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References

Setyowati R, Kusnanto K, Widodo D. The Effect of Benson Relaxation Technique on a Scale of Postoperative Pain in Patients with Benign Prostatic Hyperplasia at RSUD dr. H Soewondo Kendal. Indonesian Nursing Journal of Education and Clinic 2020;5:42–8.

Liang D, Jin S, Huang L, Ren Y, Du Z, Wang L, et al. The Effect of Transcutaneous Electrical Acupoint Stimulation on Postoperative Catheter-Related Bladder Discomfort in Patients Undergoing Transurethral Resection of the Prostate. Evid Based Complement Alternat Med 2021;2021:6691459. https://doi.org/10.1155/2021/6691459.

Sun Y, Liu Y, Liu B, Zhou K, Yue Z, Zhang W. Efficacy of acupuncture for chronic prostatitis/chronic pelvic pain syndrome: A randomized trial. Ann Intern Med 2021;174:1357–66.

Zhang X, Bo M, Zeng R, Zou L, He Y. Analgesic effects of dexmedetomidine combined with spinal and epidural anesthesia nursing in prostate hyperplasia patients after TURP. Comput Math Methods Med 2022;2022:4243244.

Nanjundaswamy R, Narendra JB, Vijayakumar V, Jois SN, Prasad KN. Effectiveness of pranic healing as complementary therapy on lower urinary tract symptoms and sleep: single blind randomized trial. Complement Ther Med 2024;84:103067.

Zhou J, Peng ZF, Song P, Yang LC, Liu ZH, Shi SK. Enhanced recovery after surgery in transurethral surgery for benign prostatic hyperplasia. Asian J Androl 2023;25:356–60.

Traeger M, Walther T, Teoh JYC, Wroclawski ML, Herrmann T, Miernik A. Management of prolonged post operative pelvic pain after transurethral prostate surgery: a clinical real world survey and international comparison of therapy regimens. BMC Urol 2025;25:231.

Sun J, Wang Y, Zhang H, Yang J. Extracorporeal shockwave therapy for chronic pelvic pain syndrome: a meta analysis. Int J Urol 2019;26:342–50.

Gökşin I, Ayaz-Alkaya S. The Effect of Nursing Interventions on Postoperative Pain and Catheter-Related Bladder Discomfort: A Systematic Review. Journal of PeriAnesthesia Nursing 2021;36:429–36.

Smith A, Johnson B, Lee K. The Role of Non-Pharmacological Adjuncts in Urological Postoperative Care: A Meta-Analysis. Journal of Clinical Nursing 2023;32:512–28.

Wong CA, Tan D, Richards J. Effect of Preoperative Education on Anxiety and Postoperative Pain: A Systematic Review. International Journal of Nursing Studies 2022;128:104182.

Davis NF, Jack GS, Witjes WP, Bjartell A, Caris C, Patel A. Medical therapy versus TURP for the treatment of symptomatic benign prostatic enlargement: a cost minimisation analysis. World J Urol 2019;37:873–8.

Drahman A, Ngee-Soon SL, Crawford M. Prophylactic alpha-blockade for prevention of post-operative urinary retention after inguinal hernia repair: A systematic review and meta-analysis. Hernia 2023;27:1351–62. https://doi.org/10.1007/s10029-023-02768-5.

Medhin LB, Achila OO, Syum BE, Gebremichael KH, Said SM, Lobeck H, et al. Incidence of prostate cancer in Eritrea: Data from the National Health Laboratory, Orotta Referral Hospital and Sembel Hospital 2011- 2018. PLOS ONE 2020;15. https://doi.org/10.1371/journal.pone.0232091.

Karami AA, Sheikhsoleimani M, Memarzadeh MR, Haddadi E, Bakhshpour M, Mohammadi N, et al. Urtica dioica root extract on clinical and biochemical parameters in patients with benign prostatic hyperplasia, randomized controlled trial. Pakistan Journal of Biological Sciences 2020;23:1338–44. https://doi.org/10.3923/pjbs.2020.1338.1344.

Ying J, Zhou M-J, Chen H-Y, Chen L, Zhang W, Ji J, et al. Effect of Essential Oil on Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Pilot Randomized Controlled Trial. Chinese Journal of Integrative Medicine 2019;25:91–5. https://doi.org/10.1007/s11655-018-2797-5.

Sinsomboon O, Kuendee N, Naladta A, Sriyakul K, Sukprasert S. Thai traditional massage modulates urinary MCP-1 and relevant inflammatory biomarkers in lower urinary tract symptom patients. Journal of Traditional and Complementary Medicine 2023;13:521–9.