title: Comparing the Efficiency and Safety of Bipolar and Monopolar Transurethral Resection for Non-Muscle Invasive Bladder Tumors: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of bipolar and monopolar transurethral resection of bladder tumor (TURBT) procedures for non-muscle invasive bladder cancer (NMIBC) patients.
  
  
  METHODS
  We searched for all studies investigating bipolar TURBT and monopolar TURBT for NMIBC patients in PubMed, Web of Knowledge, and the Cochrane Central Search Library. A systematic review and meta-analysis were performed. Efficacy was assessed by catheterization time, resection time, pathology, and recurrence rate. Safety was assessed by obturator nerve reflex, bladder perforation, hemoglobin decrease, and transfusion.
  
  
  RESULTS
  Our searches identified eight studies. Bipolar TURBT is associated with decreased resection time, catheterization time, and hemoglobin changes. There were no statistically significant differences between bipolar TURBT and monopolar TURBT for rates of obturator nerve reflex, bladder perforation, and transfusion. The grade of cautery artifact had no different between the two procedures or even was lower in the bipolar arm. There was no significant difference in recurrence rate when comparing the two procedures.
  
  
  CONCLUSIONS
  This systematic review indicates that the bipolar technique is more efficacious and safer for NMIBC patients. More large-scale, multicenter, randomized controlled studies are needed before final clinical recommendations can be made.
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University , Changsha, Hunan, China .
authors.forename: Yu
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University , Changsha, Hunan, China .
authors.forename: Hequn
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University , Changsha, Hunan, China .
authors.forename: Longfei
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University , Changsha, Hunan, China .
authors.forename: Jinbo
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University , Changsha, Hunan, China .
authors.forename: Lin
authors.initials: L
authors.lastname: Qi
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University , Changsha, Hunan, China .
authors.forename: Xiongbing
authors.initials: X
authors.lastname: Zu
mesh_terms: D006801:Humans; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D001743:Urinary Bladder / Q000473:pathology / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*