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Abstract
OBJECTIVE: To compare bipolar and monopolar transurethral resection of bladder tumor in terms of obturator nerve reflex, bladder perforation, and length of hospital stay.
METHODOLOGY: This prospective comparative study was conducted from 2 July 2025 to 2 October 2025 at the Department of Urology, Institute of Kidney Diseases, Peshawar, and involved 182 patients aged 40 to 70 years presenting with diagnosed bladder tumor, enrolled via non-probability consecutive sampling. Patients were equally divided into two groups. Patients with a history of prostatic surgery, compromised cardiac, renal, or pulmonary function, and recurrent tumors were excluded. Patients in Group A underwent bipolar resection, while patients in Group B underwent monopolar resection. The primary endpoints were obturator nerve reflex, bladder perforation, and hospital stay. Data were analyzed with SPSS 27. The Mann-Whitney U test and Chi-square/Fisher exact test were used for comparison. We considered p ≤ 0.05 significant.
RESULTS: The median age was 61 years in the bipolar group and 62 years in the monopolar group. Obturator nerve reflex occurred in 7 (7.7%) patients in the bipolar group and 18 (19.8%) in the monopolar group (p = 0.018). Bladder perforation was observed in 1 (1.1%) patient in the bipolar group and 3 (3.3%) patients in the monopolar group (p = 0.621). The median hospital stay was 2 days (IQR: 1 to 3) in the bipolar group and 3 days (IQR: 2 to 4) in the monopolar group (p < 0.001).
CONCLUSION: Bipolar transurethral resection of bladder tumor significantly reduced obturator nerve reflex; it was associated with a shorter hospital stay than monopolar transurethral resection. Bipolar TURBT offers a safer alternative for patients with bladder tumor.