Effect of obturator nerve block during transurethral resection of lateral bladder wall tumors: a comparison of monopolar and bipolar TUR-BT regarding the presence of detrusor muscle in tumor specimens and recurrence of disease

Abstract

Aim Any unintentional stimulation during electroresection results in adductor contraction and resultant sudden leg movement, which may in turn lead to perforation of bladder or incomplete resection. To avoid this reaction, obturator nerve block (ONB) and bipolar resection is effective to decrease the jerk. Patients and methods A prospective randomized, single-blind study was conducted during 2014–2018. A total of 74 patients were classified into four groups. Group I included 18 patients who received monopolar transurethral resection of bladder tumor (TUR-BT) and group II included 21 patients who received bipolar TUR-BT. Group III included 16 patients who received ONB and monopolar TURT. Group IV included 19 patients who received ONB and bipolar TUR-BT. Results The median age for group 1 was 61.3 years, and mean operation time was 38.2 min. For group II, median age was 63.0 years, and operation time was 33.55 min. For group III, median age was 65.2 years, and operation time was 31.50 min. For group IV, median age was 64.0 years and operation time was 29.25 min. No recurrence occurred in 83.3% (15/18) in group IV, and no recurrence occurred in 73.3% of group III in comparison with 65% of group II and 68% of group I. Conclusion Bipolar TUR-BT with ONB is an effective method to have muscle in the specimen and to reduce incidence of early recurrence (incomplete resection) and jerks.