MP49-13 SAFETY AND EFFICACY OF MONOPOLAR VS BIPOLAR TRANSURETHRAL RESECTION OF BLADDER TUMOR

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive I (MP49)1 Apr 2020MP49-13 SAFETY AND EFFICACY OF MONOPOLAR VS BIPOLAR TRANSURETHRAL RESECTION OF BLADDER TUMOR Manish Pradhan* and Diwas Gnyawali Manish Pradhan*Manish Pradhan* More articles by this author and Diwas GnyawaliDiwas Gnyawali More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000911.013AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Since its inception, TURBT has been performed with monopolar cautery. Bipolar resection has now been proved to be a safe, effective alternative for prostate TUR. Initial studies of bipolar TURBT were promising with fewer fluid and electrolyte abnormalities, and a decreased incidence of obturator jerk. However, no high level evidence exists and the exact role of bipolar TURBT remains undefined. Hence this study was intended to compare the safety and efficacy of bipolar and monopolar resection of bladder tumor. METHODS: This was a randomized control trial done for one year with patients being allotted randomly into bipolar and monopolar arm. The study was carried out in the department of urology and transplant surgery TUTH. All consecutive patients undergoing TURBT for suspected bladder tumors were eligible for the study. Diagnosis was based on imaging and/or cystoscopy. Exclusion criteria included refusal to participate, unfitness for spinal anesthesia and lack of tumor in lateral wall. Primary objective was to compare the incidence of obturator jerk in monopolar and bipolar TURBT. The secondary objective was to study and compare the decrease in hemoglobin, recoagulation and transfusion requirements, bladder perforation, decrease in sodium, resection syndrome and resection time, hospital stay in two groups, detrussor muscle identification and pathological quality of resected specimen. RESULTS: A total of 82 transurethral resections were done over the study period. After exclusion of 12 patients, 70 patients, 36 in monopolar and 34 in bipolar arms, were analyzed. Both the study groups were comparable for age, sex and tumor size. The incidence of obturator jerk was greater in monoplar arm (47.2% vs 26.4%, p=0.073). There was no significance difference in most of the secondary outcomes. The only differences was in lesser hemoglobin drop in bipolar arm (0.49gm/dl vs 0.98gm/dl, p=0.016) and lesser resection time seen in bipolar arm (33.0 mins vs 46.8mins, p=0.008). CONCLUSIONS: The bipolar transurethral resection of bladder tumor was not superior to monopolar resection with respect to the obturator jerk, recoagulation and transfusion requirements, bladder perforation, decrease in sodium, resection syndrome, hospital stay and pathological quality of resected specimen. However, there was significantly lower hemoglobin drop and resection time was significantly less when bipolar resection was used. Source of Funding: Urological department © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e746-e746 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Manish Pradhan* More articles by this author Diwas Gnyawali More articles by this author Expand All Advertisement PDF downloadLoading ...