title: Effect of obturator nerve block during transurethral resection of lateral bladder wall tumors on the presence of detrusor muscle in tumor specimens and recurrence of the disease.
abstract: We investigated the effect of spinal anesthesia combined with obturator nerve block (ONB) during the transurethral resection of lateral bladder wall tumors (TUR-BT) on the presence of detrusor muscle tissue in tumor specimens and on tumor recurrence. TUR-BT was performed on 96 patients with a lateral bladder wall tumor under spinal anesthesia in our clinic between January 2011 and December 2015. The patients were divided into two groups: 49 patients only received spinal anesthesia and 47 patients received spinal anesthesia combined with ONB. The groups were retrospectively compared in terms of adductor muscle contraction, bladder perforation, complete tumor resection, presence of muscle tissue in the pathology material, and recurrence rate during follow-up. The obturator reflex was significantly observed in the non-ONB group (p < 0.05). In the ONB group, the percentages of complete resection and detrusor muscle tissue were significantly higher (p = 0.003 and p = 0.001, respectively). The postoperative recurrence rate was found to be significantly higher in the non-ONB group than in the ONB group (p = 0.025). Spinal anesthesia combined with ONB during TUR-BT prevent obturator reflex and facilitate complete resection including detrusor muscle tissue, independent from the size or number of tumors, thus reducing the recurrence of the disease.
authors.affiliation: Department of Urology, Erzincan University Mengucek Gazi Research and Training Hospital, Erzincan, Turkey. Electronic address: drguven85@hotmail.com.
authors.forename: Guven
authors.initials: G
authors.lastname: Erbay
authors.affiliation: Department of Anesthesiology, Erzincan University Mengücek Gazi Training and Research Hospital, Erzincan, Turkey.
authors.forename: Fethi
authors.initials: F
authors.lastname: Akyol
authors.affiliation: Department of Urology, Mersin Toros State Hospital, Mersin, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Karabakan
authors.affiliation: Department of Urology, Erzincan University Mengucek Gazi Research and Training Hospital, Erzincan, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Celebi
authors.affiliation: Department of Urology, Erzincan University Mengucek Gazi Research and Training Hospital, Erzincan, Turkey.
authors.forename: Ercument
authors.initials: E
authors.lastname: Keskin
authors.affiliation: Department of Urology, Erzincan University Mengucek Gazi Research and Training Hospital, Erzincan, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Hirik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal / Q000379:methods; D000779:Anesthetics, Local; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery; D009407:Nerve Block / Q000379:methods*; D009776:Obturator Nerve; D018666:Ureteroscopy / Q000379:methods; D001743:Urinary Bladder / Q000294:innervation / Q000473:pathology / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine
keywords: Bladder tumor; Detrusor muscle; Obturator nerve block; Transurethral resection complication; Tumor recurrence