You have accessJournal of UrologyBladder Cancer: Superficial1 Apr 2014MP56-08 INCIDENCE OF SEVERE BLADDER INJURY AMONG THE MONOPOLAR AND BIPOLAR TRANSURETHRAL RESECTION OF BLADDER TUMOR: A POPULATION-BASED STUDY BASED ON 28141 CASES Toru Sugihara, Hideo Yasunaga, Hiromasa Horiguchi, Michael Kattan, Kiyohide Fushimi, and Yukio Homma Toru SugiharaToru Sugihara More articles by this author , Hideo YasunagaHideo Yasunaga More articles by this author , Hiromasa HoriguchiHiromasa Horiguchi More articles by this author , Michael KattanMichael Kattan More articles by this author , Kiyohide FushimiKiyohide Fushimi More articles by this author , and Yukio HommaYukio Homma More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1576AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives The both of monopolar and bipolar transurethral resection of bladder tumor (M-TURBT and B-TURBT) involve the risk of the bladder injury. Most of the injuries were treatable conservatively, however, if a large and severe perforation take place, a bladder repair surgery or an insertion of a drainage can be required. A B-TURBT is considered to be safer, however, the evaluation of its effectiveness in the clinical practice is limited. We compared the risks of severe bladder injury among M-TURBT and B-TURBT using the Japanese population-based database. Methods From the Japanese Diagnosis Procedure Combination database 2007–2012, we identified the patients who underwent TURBTs for urothelial carcinoma whose stage is I or II. We excluded TURBTs performed within 180 days from the previous TURBT, because those can be a second resection for residual tumor. M-TURBT and B-TURBT could be distinguished by the intraoperative use or non-use of D-sorbitol solution, which is the only nonelectrolyte bladder irrigation fluid for M-TURBT available in Japan. The severe bladder injury was defined as a bladder repair surgery or an insertion of abdominal drainage placement within 7 days from TURBT. Multivariate analyses were conducted for the severe bladder injury with the variables including TURBT type, gender, comorbidities (Charlson comorbidity index), oncological stage, past history of TURBT, hospital type (academic or not), and hospital volume. Results Overall, 19953 M-TURBT cases and 8188 B-TURBT cases were identified. Among the M-TURBT and B-TURBT groups, the bladder repair surgery occurred in 0.02% and 0.01% (Chi-square test, p = 0.503), respectively, and the drainage placement occurred in 0.56% and 0.34% (p = 0.018), respectively. The multivariate analyses showed the incidence of the severe bladder injury were significantly associated with TURBT type (OR of B-TURBT, 0.933), age (OR, 1.014), gender (OR of female, 0.959), Charlson comorbidity index (OR, 1.181), hospital volume (OR, 0.997), Academic hospital (OR, 0.756), oncological stage (OR of stage II, 1.844), and past history of TURBT (OR, 0.582). (All p < 0.05) Conclusions The severe bladder injury was very rare (0.51%), however can happen regardless M-TURBT or B-TURBT. This is the first study showing that B-TURBT was associated with lower risk of the severe bladder injury compared with M-TURBT based on the data from the actual clinical practice, and this result would support the safety attractiveness of B-TURBT. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e566 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Toru Sugihara More articles by this author Hideo Yasunaga More articles by this author Hiromasa Horiguchi More articles by this author Michael Kattan More articles by this author Kiyohide Fushimi More articles by this author Yukio Homma More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...