Comparison of outcome of conventional bipolar vs. laser en bloc transurethral resection of bladder tumor: A prospective study

Background: Urothelial carcinoma of bladder (UBC) is the second-most common urological malignancy and represents a growing healthcare problem worldwide. Although the vast majority of newly diagnosed bladder cancers are for nonmuscle-invasive disease and may be treated with endourological procedures,...

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Main Authors: Apurv Shukla, Partha Protim Mondal, Sudipta Kumar Singh, Shashi Kant Tewary, Arvind Arvind, Ankit Agarwal, Ranjan Kumar Dey
Format: Article
Language:English
Published: Manipal College of Medical Sciences, Pokhara 2025-08-01
Series:Asian Journal of Medical Sciences
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Online Access:https://ajmsjournal.info/index.php/AJMS/article/view/4577
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author Apurv Shukla
Partha Protim Mondal
Sudipta Kumar Singh
Shashi Kant Tewary
Arvind Arvind
Ankit Agarwal
Ranjan Kumar Dey
author_facet Apurv Shukla
Partha Protim Mondal
Sudipta Kumar Singh
Shashi Kant Tewary
Arvind Arvind
Ankit Agarwal
Ranjan Kumar Dey
author_sort Apurv Shukla
collection DOAJ
description Background: Urothelial carcinoma of bladder (UBC) is the second-most common urological malignancy and represents a growing healthcare problem worldwide. Although the vast majority of newly diagnosed bladder cancers are for nonmuscle-invasive disease and may be treated with endourological procedures, correct initial staging is critical. The quality of transurethral resection of bladder tumors (TURBT) strongly determines patient prognosis and overall UBC treatment costs Goals of new strategies should include avoiding second TURBTs and lowering overall treatment regimens. Aims and Objectives: To compare the safety, efficacy, and outcome of conventional bipolar and laser en bloc resection of bladder tumors in nonmuscle-invasive bladder cancer. Materials and Methods: This is a prospective study. The study period will be from January 2023 to May 2024. The study is proposed to be conducted in the Department of Urology, R.G. Kar Medical College and Hospital.101 patients were included in this study. Results: Tumor sizes were nearly similar in both groups (mean 2.1 cm). The higher number of patients had detrusor muscle in their specimen (46 [90.2%]) in the laser group compared to the bipolar group (30 [60.0%]) (P=0.0004). 10 (20.0%) patients had obturator nerve reflex in bipolar group and none in the laser group. A statistically significant (P<0.0001) increase in operative time was observed in bipolar group (43.1000±13.3589.) compared to the laser group (33.5294±7.2315). Hospital stay was higher in the bipolar group (2.3200±0.8437) compared to the laser group (2.1373±0.3475). 10 (20.0%) patients had recurrence in the bipolar group compared to the laser group (8 [15.7%]). Conclusion: The laser en bloc TURBT demonstrated superior advantages in terms of reduced intraoperative bleeding, shorter catheterization time, quicker postoperative recovery, and decreased risk of obturator nerve reflex, thereby decreasing the risk of bladder perforation and higher detrusor muscle acquisition rate, thereby decreasing the need for restage TURBT as compared to the conventional bipolar technique. In addition, the en bloc approach with laser minimized tumor fragmentation, potentially reducing the risk of residual tumor cells and recurrence.
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spelling doaj-art-600d8b24ac6d4f0aa6f839f213a218cc2025-08-20T03:34:13ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762025-08-011688893https://doi.org/10.71152/ajms.v16i8.4577Comparison of outcome of conventional bipolar vs. laser en bloc transurethral resection of bladder tumor: A prospective studyApurv Shukla 0https://orcid.org/0009-0009-6019-7726Partha Protim Mondal1https://orcid.org/0000-0001-9971-6698Sudipta Kumar Singh 2https://orcid.org/0000-0002-4876-1090Shashi Kant Tewary 3https://orcid.org/0000-0002-4958-7872Arvind Arvind 4https://orcid.org/0009-0001-5834-9438Ankit Agarwal 5https://orcid.org/0009-0007-4979-2191Ranjan Kumar Dey 6https://orcid.org/0000-0003-0364-4218Postgraduate Resident, Department of Urology, RG Kar Medical College, Kolkata, West Bengal, India Associate Professor, Department of Urology, RG Kar Medical College, Kolkata, West Bengal, India Assistant Professor, Department of Urology, RG Kar Medical College, Kolkata, West Bengal, India Assistant Professor, Department of Urology, RG Kar Medical College, Kolkata, West Bengal, India Postgraduate Resident, Department of Urology, RG Kar Medical College, Kolkata, West Bengal, IndiaPostgraduate Resident, Department of Urology, RG Kar Medical College, Kolkata, West Bengal, India Ex Professor and Ex Head, Department of Urology, RG Kar Medical College, Kolkata, West Bengal, India Background: Urothelial carcinoma of bladder (UBC) is the second-most common urological malignancy and represents a growing healthcare problem worldwide. Although the vast majority of newly diagnosed bladder cancers are for nonmuscle-invasive disease and may be treated with endourological procedures, correct initial staging is critical. The quality of transurethral resection of bladder tumors (TURBT) strongly determines patient prognosis and overall UBC treatment costs Goals of new strategies should include avoiding second TURBTs and lowering overall treatment regimens. Aims and Objectives: To compare the safety, efficacy, and outcome of conventional bipolar and laser en bloc resection of bladder tumors in nonmuscle-invasive bladder cancer. Materials and Methods: This is a prospective study. The study period will be from January 2023 to May 2024. The study is proposed to be conducted in the Department of Urology, R.G. Kar Medical College and Hospital.101 patients were included in this study. Results: Tumor sizes were nearly similar in both groups (mean 2.1 cm). The higher number of patients had detrusor muscle in their specimen (46 [90.2%]) in the laser group compared to the bipolar group (30 [60.0%]) (P=0.0004). 10 (20.0%) patients had obturator nerve reflex in bipolar group and none in the laser group. A statistically significant (P<0.0001) increase in operative time was observed in bipolar group (43.1000±13.3589.) compared to the laser group (33.5294±7.2315). Hospital stay was higher in the bipolar group (2.3200±0.8437) compared to the laser group (2.1373±0.3475). 10 (20.0%) patients had recurrence in the bipolar group compared to the laser group (8 [15.7%]). Conclusion: The laser en bloc TURBT demonstrated superior advantages in terms of reduced intraoperative bleeding, shorter catheterization time, quicker postoperative recovery, and decreased risk of obturator nerve reflex, thereby decreasing the risk of bladder perforation and higher detrusor muscle acquisition rate, thereby decreasing the need for restage TURBT as compared to the conventional bipolar technique. In addition, the en bloc approach with laser minimized tumor fragmentation, potentially reducing the risk of residual tumor cells and recurrence.https://ajmsjournal.info/index.php/AJMS/article/view/4577bladder tumor; laser en bloc resection; bipolar transurethral resection of bladder tumors and postoperative recovery
spellingShingle Apurv Shukla
Partha Protim Mondal
Sudipta Kumar Singh
Shashi Kant Tewary
Arvind Arvind
Ankit Agarwal
Ranjan Kumar Dey
Comparison of outcome of conventional bipolar vs. laser en bloc transurethral resection of bladder tumor: A prospective study
Asian Journal of Medical Sciences
bladder tumor; laser en bloc resection; bipolar transurethral resection of bladder tumors and postoperative recovery
title Comparison of outcome of conventional bipolar vs. laser en bloc transurethral resection of bladder tumor: A prospective study
title_full Comparison of outcome of conventional bipolar vs. laser en bloc transurethral resection of bladder tumor: A prospective study
title_fullStr Comparison of outcome of conventional bipolar vs. laser en bloc transurethral resection of bladder tumor: A prospective study
title_full_unstemmed Comparison of outcome of conventional bipolar vs. laser en bloc transurethral resection of bladder tumor: A prospective study
title_short Comparison of outcome of conventional bipolar vs. laser en bloc transurethral resection of bladder tumor: A prospective study
title_sort comparison of outcome of conventional bipolar vs laser en bloc transurethral resection of bladder tumor a prospective study
topic bladder tumor; laser en bloc resection; bipolar transurethral resection of bladder tumors and postoperative recovery
url https://ajmsjournal.info/index.php/AJMS/article/view/4577
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