EN BLOC RESECTION OF BLADDER TUMOR(EBRT) USING MONOPOLAR CAUTERY; A TERTIARY HOSPITAL EXPERIENCE.

Abstract

Bladder cancer is a growing health problem with the second most common urological malignancy. It accounts for around 7% of a new cancer diagnosis. Tobacco smoking is the most important risk factor accounting for around 50% of cases. Tobacco smokes contain aromatic amines and polycyclic hydrocarbons which are excreted through kidneys. The goal of transurethral biopsy in NMIBC(non-muscle invasive bladder cancer) is to make the correct diagnosis and completely remove all visible lesions which can be either resected piecemeal or en bloc. The presence of detrusor muscle in the specimen is an important factor for planning treatment and prognosis. Here we share our experience of EBRT using monopolar cautery describing the feasibility, safety, and adequacy of the procedure in the management of small urinary bladder tumors. The study was conducted in the Department of Urology, SMS Medical College, and attached hospitals. All the patients with clinical NMIBC during study duration were admitted and a total of 25 patients above the age of 18yrs, having papillary bladder tumors less than 3 cm were included in the study. Complete resection by the en bloc technique was achieved in all 25 cases with no requirement of conversion to conventional TURBT. Our study also shows the presence of detrusor muscle in 22 specimens out of 25. And only two patients developed severe bleeding which needed a blood transfusion. Thus, ERBT using monopolar cautery is safe and feasible for the complete resection of NMIBCs with a high rate of detrusor-positive specimens in the selected patient population.