To explore the effectiveness and safety of the extreme flexion and abduction hip combined with a stirrup-shaped multifunctional leg frame position in preventing obturator nerve reflex during plasma resection of bladder tumors (TUR-BT). A total of 112 patients with bladder tumors were included in the study. The control group was placed in a lithotomy position, while the experimental group was placed in an extreme flexion and abduction hip combined with a stirrup-shaped multifunctional leg frame position. The grade of leg jerking, operation time, and some operative complications were compared between groups. The operation time, bleeding volume, the grade of leg jerking, second TUR-BT, and acquisition of detrusor muscle were significantly better in the experimental group compared to the control group (P = 0.018, P = 0.013, P < 0.001, P = 0.041, and P < 0.001, respectively). The grade of leg jerking in the experimental group was extremely low (distributed in grade 1 and 2), and there were no severe reactions in grade 3 and 4. The extreme flexion and abduction hip combined with a stirrup-shaped multifunctional leg frame position for TUR-BT is a safe and effective treatment method that can effectively prevent obturator nerve reflex, reduce complications, improve surgical efficacy, and reduce anesthesia dependence and risk.