Role of surgeon experience in the outcome of transurethral resection of bladder tumors

Background: Transurethral resection of supercial bladder tumours is well known to be gold standard management. It is evident from the literature that initial TURBT is not enough for accurate pathological staging in non-muscle invasive bladder cancer. Aim: Our study is aimed at role of restaging TURBT in detection of residual disease for pathological upstaging in these high-risk patients to plan appropriate treatment. Methods: This is a prospective study of 32 patients with initially diagnosed Ta/T1 high-grade bladder cancer who had restaging TURBT in a study by Department of urology, NIMS, Hyderabad between January 2016 and December 2018 were included. Low-grade tumors, carcinoma in situ and muscle invasive bladder tumors were excluded. Data elements collected on patient demographics, presence of residual disease, disease progression and recurrence in the follow-up period. The data was statistically analyzed using descriptive statistics by SPSS version 17. P value <=0.05 is considered as statistically signicant. Results: The mean age for patients included in the study was 60.5 years. In our study, we found that 15 out of 32 cases (47%) has been detected with residual disease ensuring that single TURBT may not been efcient with complete removal of tumor. Six out of 32 cases (19%) had upstaging and 5 out of 32 cases had concurrent carcinoma in situ leading to change in treatment. Therefore, 11 out of 32 cases (34%) has been under staged by initial TURBT were adequately staged by restaging TURBT and subjected to radical cystoprostatectomy or chemo radiotherapy, This mandates the need for restaging TURBT at 6-8 weeks interval for adequate staging and management. Upstaging on restaging TURBT was seen in 19%. The progression-free survival rate at 16 months was 25 % in patients with residual tumour and 94% in cases without residual disease. Conclusion: We conclude that restaging TURBT effectively detects residual disease, helping pathological upstaging and planning denitive treatment in non-muscle invasive high-grade bladder tumour.

Download Full-text

Role of second-look transurethral resection of bladder tumors for newly diagnosed T1 bladder cancer: Experience at a single center

Urological Science ◽

10.4103/uros.uros_17_17 ◽

2018 ◽

Vol 0 (0) ◽

pp. 0

Author(s):

AlexChien-Hwa Liao ◽

Wen-Hsin Tseng ◽

Kun-Hung Shen ◽

Chun-Hao Chen ◽

Chien-Liang Liu ◽

...

Keyword(s):

Bladder Cancer ◽

Transurethral Resection ◽

Newly Diagnosed ◽

Single Center ◽

Bladder Tumors ◽

Second Look ◽

Cancer Experience

Download Full-text

Comparison of Endoscopic Versus Percutaneous Approach (Blind) to Control the Obturator Jerk in Patients Undergoing Transurethral Resection of Bladder Tumors Under Spinal Anesthesia

Bangladesh Journal of Urology ◽

10.3329/bju.v21i2.49885 ◽

2020 ◽

Vol 21 (2) ◽

pp. 120-126

Author(s):

Alamgir Md ◽

Karim Km Monwarul ◽

Nandy SP ◽

Md Monwar Ul Haque ◽

Sakhawat Mahmud Khan

Keyword(s):

Statistical Analysis ◽

Spinal Anesthesia ◽

Transurethral Resection ◽

Bladder Tumor ◽

Complete Resection ◽

Satisfaction Level ◽

Bladder Tumors ◽

Percutaneous Approach ◽

Group A ◽

Group B

Objective: The aim of the study was to compare the endoscopic versus percutaneous approach (blind) to control the obturator jerk in patients undergoing transurethral resection of bladder tumors under spinal anesthesia. Materials and methods: A prospective observational study was performed in Department of Urology, Chittagong Medical College, Chittagong and some Private Hospitals (Ltd.) in Chittagong city during the period from January 2016 to June 2016. Total 100 patients were grouped into two, on alternate basis. Fifty(50) patients in group- A conducted with endoscopic infiltration with 20ml of injection 2% lignocaine at the bladder tumor base and another 50 patients in group-B, conducted with blind percutaneous technique with same drug and volume ( 20ml inj.2% lignocaine) to control obturator jerk. Severity of obturator jerk in both procedure, percentage of complete resection, ONB procedure related time, ONB procedure related complications and surgeon’s satisfaction level were recorded and compared between two approaches. Chi-square analysis was performed to compare the ease of approach and outcome of the two techniques. A value of P<0.05 was considered statistically significant. Results: The mean age of the patients were 59.44+7.681. In group-A, 50 patients were given inj. 2% lignocaine endoscopically at the bladder tumor base to control obturator jerk. Twenty five patients (50%) had no jerk, 20 patients(40%) developed mild jerk and 5 patients (10%) developed moderate jerk and no patients developed severe jerk. Second attempt was taken in moderate jerk patients (5 patients) and succeeded in 3(6%) patients. So, in this group, complete resection of bladder tumor was possible in 96%. In group B, complete resection of bladder tumor was possible in 84%. Statistical analysis was done and result is significant in case of endoscopic procedure to control obturator jerk(p<0.05). ONB Procedure related time was <20 mins. in 32(64%) patients in group-A and 45 (90%) patients in group- B. 20 mins. or more time was required for 18 (36%) patients in group-A and 5 (10%) patients in group-B. Statistical analysis was done and result is significant in percutaneous (blind) technique (p<0.05). ONB procedure related complications in group-A and Group –B were noted. Statistical analysis was done and result is insignificant (p>0.05). Surgeons satisfaction level were recorded on the basis of obturator jerk block and complete resection and which was statistically significant in favour of endoscopy group (p<0.05). Conclusion: It is concluded that endoscopic injection of 2% lignocaine into the bladder tumor base is better in case of jerk elimination and complete resection than blind percutaneous approach. Though, ONB procedure related time was significantly less in percutaneous group. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.120-126

Download Full-text

The Role of Urinary Fibronectin and Telomerase in Patients with Superficial Bladder Cancer after Transurethral Resection Treated with BCG

Bulletin of Egyptian Society for Physiological Sciences ◽

10.21608/besps.2010.36166 ◽

2010 ◽

Vol 30 (1) ◽

pp. 73-102

Author(s):

Ghada Abdel Aleem ◽

Hala Hamouda ◽

Tarek Gameel ◽

Mona Abdel-Azem

Keyword(s):

Bladder Cancer ◽

Transurethral Resection ◽

Superficial Bladder Cancer

Download Full-text

Role of Different Types of Anti Androgen in Reduction of Perioperative Bleeding In Transurethral Resection of Prostate for Treatment of Large Size Prostate

Zagazig University Medical Journal ◽

10.21608/zumj.2020.21740.1668 ◽

2020 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

abobaker mohamed ◽

Khalid Abdelsamad ◽

Hazem Elgalaly ◽

Ahmed Eliwa

Keyword(s):

Transurethral Resection ◽

Transurethral Resection Of Prostate ◽

Large Size ◽

Perioperative Bleeding ◽

Different Types

Download Full-text

The role of preoperative dutasteride in reducing bleeding during transurethral resection of the prostate: A systematic review and meta-analysis of randomized controlled trials

Asian Journal of Urology ◽

10.1016/j.ajur.2021.05.011 ◽

2021 ◽

Author(s):

Yudhistira Kloping ◽

Niwanda Yogiswara ◽

Yusuf Azmi

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Transurethral Resection ◽

Meta Analysis ◽

Controlled Trials ◽

Randomized Controlled

Download Full-text

Comparison of Thulium Laser Resection of Bladder Tumors and Conventional Transurethral Resection of Bladder Tumors for Non-Muscle-Invasive Bladder Cancer

Urologia Internationalis ◽

10.1159/000514042 ◽

2021 ◽

pp. 1-6

Author(s):

Zheng Liu ◽

Yucong Zhang ◽

Guoliang Sun ◽

Wei Ouyang ◽

Shen Wang ◽

...

Keyword(s):

Bladder Cancer ◽

Transurethral Resection ◽

Invasive Bladder Cancer ◽

Perioperative Outcomes ◽

Thulium Laser ◽

Bladder Tumors ◽

Muscle Invasive Bladder Cancer ◽

Laser Resection ◽

Baseline Characteristics ◽

Muscle Invasive

Introduction: The thulium laser resection of bladder tumors (TmLRBT) was increasingly used in the treatment of non-muscle-invasive bladder cancer (NMIBC) recently, and here we report the relevant outcomes of our institution to evaluate its efficacy and safety. Methods: We retrospectively collected the data of NMIBC patients who underwent either TmLRBT or transurethral resection of bladder tumor (TURBT). The baseline characteristics and perioperative outcomes were compared in these 2 groups. Results: The TmLRBT had a higher rate of detrusor identification than TURBT (97.4 vs. 87.6%, p = 0.001). After screening, 134 patients who underwent TmLRBT and 152 patients who received TURBT were enrolled in the analysis, and their baseline characteristics were similar. During the TURBT, 24 (15.8%) obturator nerve reflexes and 9 (5.9%) bladder perforations occurred, while none happened during the TmLRBT. After surgery, TmLRBT patients had fewer postoperative gross hematuria (38.1 vs. 96.7%, p < 0.001) and postoperative irrigation (27.6 vs. 92.7%, p < 0.001), and its irrigation duration was significantly shorter (2.3 vs. 3.3 day, p < 0.001). During the follow-up, no significant difference in the recurrence rate was detected (p = 0.315). Conclusions: TmLRBT is a safer technique than conventional TURBT in the treatment of NMIBC, and it could offer better specimens for pathologic assessment while the cancer control was not compromised.

Download Full-text