Comparison of Monopolar Versus Bipolar Repeat Transurethral Resection of Bladder Tumours

Objective: To compare the effects of monopolar and bipolar energy sources on efficacy of both techniques and possible complications in bladder cancer patients undergoing repeat Transurethral resection of bladder tumour (re-TURBT). Study Design: Descriptive study. Place and Duration of the Study: University of Health Science, Izmir Bozyaka Research and Training Hospital, Turkiye, from 2019 to 2021. Methodology: Patients undergoing re-TURBT were inducted. Patients with residual tumour at initial TURBT, recurrent bladder cancer and patients with a non-urothelial pathology report in initial TURBT were excluded. The primary outcome was the complication ratio of the TURBT which were obturator reflex, bladder wall perforation, coagulum retention, fever, and TUR syndrome. The secondary outcome was the efficacy of the TURBT procedure, such as complete tumour resection, adequate sampling of deep muscle tissue, and sampling of qualified tissues without any thermal damage. Results: One hundred and twenty-three patients were enrolled; 75 patients in re-M-TURBT group and 48 patients in re-B-TURBT group were analysed. Demographic and tumour characteristics, and complication rates according to the Clavien classification, were similar between the two groups (p = 0.302). The catheterisation time was shorter significantly in the bipolar re-TURBT group (median 4vs. 3 days, respectively, p = 0.025). Conclusion: Monopolar and Bipolar energy sources are techniques that can be used safely in re-TURBT in terms of both appropriate pathology sampling (adequate muscle tissue sampling, cautery artifact) and complication (obturator reflex, hyponatraemia, haemoglobin decrease, bleeding) rates.