Purpose To evaluate the impact of maximal transurethral resection of bladder tumor (TURBT) on perioperative outcomes following radical cystectomy (RC). Methods This study included 310 patients who underwent RC for the diagnosis of bladder urothelial carcinoma. Of these, 146 patients had a history of maximal TURBT (TURBT group) and 164 did not (non-TURBT group). Patients in the TURBT group were categorized into four groups according to the time interval between the last TURBT and RC: <= 1 month, 1-3 months, 3-6 months, and > 6 months. Additionally, the TURBT group was stratified into a single TURBT group and multiple TURBT group. Perioperative outcomes were compared between the groups. Results The median duration of pelvic drainage tube retention was longer in the TURBT group (11 vs. 9 days, p = 0.037). The incidence of Clavien-Dindo >= 3 complications (15.3% vs. 7.3%, p = 0.031) and ICU admission rate(10.4% vs. 4.5%, p = 0.048) were higher in the TURBT group. Statistically significant differences were observed in the incidence of Clavien-Dindo >= 3 complications (p = 0.007), reoperation rates (p = 0.041), incidence of sepsis (p = 0.022), and urinary complications (p = 0.024) across the four groups stratified by the time interval between TURBT and RC, with the 1-3 to months group demonstrating the highest incidence. There was no significant difference in perioperative outcomes between patients who underwent a single TURBT and those who underwent multiple TURBT. Conclusion Patients with a history of maximal TURBT, especially those who underwent RC within 1-3 months after maximal TURBT, have an increased risk of unfavorable perioperative outcomes following RC.
