Comparing the short-term outcomes and complications of monopolar and bipolar transurethral resection of non-muscle invasive bladder cancers: a prospective, randomized, controlled study.
OBJECTIVE
To compare perioperative outcomes and complications of plasmakinetic bipolar and monopolar transurethral resection of bladder tumors (TURBT) in patients with non-muscle invasive bladder cancer (NMIBC).


METHODS
Between March and December 2015, a total of 130 consecutive patients underwent TURBT for NMIBC. Patients were equally randomized into monopolar TURBT (M-TURBT) and bipolar TURBT (B-TURBT) groups. Primary outcome of this study was safety of the procedures including obturator jerk, bladder perforation, clot retention, febrile urinary tract infection and TUR syndrome. The secondary outcome was efficacy of both TURBT procedures, including complete tumor resection, sampling of the deep muscle tissue and sampling of the qualified tissues that without any thermal damage.


RESULTS
Complete tumor resection rate was higher in B-TURBT than M-TURBT (89.2% vs 78.5%, respectively), but the difference was not significant (p=0.152). No significant differences were found between the muscle tissue sampling rates (64.6% vs 72.3%, p=0.345) and the numbers of patients with thermal tissue damage (7 patients vs 3 patients, p=0.194). Obturator jerk was detected in 21.5% of the patients in M-TURBT group and 4.6% of the patients in B-TURBT group, and this difference was statistically significant (p=0.013). Bladder perforation was significantly higher in M-TURBT group than B-TURBT (21.5 % vs 6.1%, p=0.039).


CONCLUSIONS
Bipolar TURBT had significantly lower obturator jerk and bladder perforation than monopolar. B- TURBT is a reasonable treatment modality in patients with NMIBC.
Department of Urology. Bozyaka Training and Research Hospital. Izmir. Turkey.
Deniz
D
Bolat
Department of Urology. Bozyaka Training and Research Hospital. Izmir. Turkey.
Bulent
B
Gunlusoy
Department of Urology. Bozyaka Training and Research Hospital. Izmir. Turkey.
Tansu
T
Degirmenci
Department of Urology. Bozyaka Training and Research Hospital. Izmir. Turkey.
Yasin
Y
Ceylan
Department of Urology. Bozyaka Training and Research Hospital. Izmir. Turkey.
Salih
S
Polat
Department of Urology. Bozyaka Training and Research Hospital. Izmir. Turkey.
Erhan
E
Aydin
Department of Urology. Bozyaka Training and Research Hospital. Izmir. Turkey.
Ozgu
O
Aydogdu
Department of Urology. Bozyaka Training and Research Hospital. Izmir. Turkey.
Zafer
Z
Kozacioglu
D000368:Aged; D015653:Cystectomy / Q000379:methods*; D004598:Electrosurgery / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*