Transurethral Resection of Bladder Tumour: Safe Implementation of Bipolar Technique

Abstract

Background: Traditionally, monopolar transurethral resection was the standard surgery for bladder tumors. After developing the bipolar technique, it was noticed that patients’ morbidity was reduced. We aim to compare bipolar and monopolar transurethral resection of bladder tumors in terms of efficacy, safety, and oncological outcomes. Patients and Methods: Clinical records of sixty patients with newly diagnosed bladder cancer who underwent either monopolar or bipolar transurethral resection between March 2019 and April 2021 were prospectively reviewed. Results: Thirty patients were included in each group. The mean age in monopolar and bipolar arms was 59.9 and 57.5 years, respectively. The obturator reflex occurred in 13.33% and 36.66% of the bipolar and monopolar arms, respectively (p = 0.032). Bladder perforation was reported in 2 cases in the monopolar arm. The resection time was significantly longer for the monopolar arm (25.45 Vs 22.85 minutes). Also, the monopolar arm reported longer mean irrigation (23.34 Vs 20.11, p = 0.039), with 1 TUR syndrome reported in the monopolar arm. The mean hemoglobin drop was more in the monopolar arm (0.9 Vs 0.5 gm/dl, p = 0.041). No statistical significance was reported regarding the histopathology results, and one patient in the monopolar group did not have muscle in his specimen. There was no statistically significant difference in recurrence and prognosis between both groups. Conclusions: The bipolar technique has demonstrated its reliability and efficiency as a surgical procedure, providing various advantages while minimizing the risk of complications.