Abstract
Purpose
Our aim was to investigate the detrusor muscle sampling rate after monopolar versus bipolar transurethral resection of bladder tumor (TURBT).
Methods
This was a single-center, prospective, randomized, phase III trial on monopolar versus bipolar TURBT. Baseline patient characteristics, disease characteristics and perioperative outcomes were compared, with the primary outcome being the detrusor muscle sampling rate in the TURBT specimen. Multivariate logistic regression analyses on detrusor muscle sampling were performed.
Results
From May 2012 to December 2015, a total of 160 patients with similar baseline characteristics were randomized to receive monopolar or bipolar TURBT. Fewer patients in the bipolar TURBT group required postoperative irrigation than patients in the monopolar TURBT group (18.7 vs. 43%; p = 0.001). In the whole cohort, no significant difference in the detrusor muscle sampling rates was observed between the bipolar and monopolar TURBT groups (77.3 vs. 63.3%; p = 0.057). In patients with urothelial carcinoma, bipolar TURBT achieved a higher detrusor muscle sampling rate than monopolar TURBT (84.6 vs. 67.7%; p = 0.025). On multivariate analyses, bipolar TURBT (odds ratio [OR] 2.23, 95% confidence interval [CI] 1.03–4.81; p = 0.042) and larger tumor size (OR 1.04, 95% CI 1.01–1.08; p = 0.022) were significantly associated with detrusor muscle sampling in the whole cohort. In addition, bipolar TURBT (OR 2.88, 95% CI 1.10–7.53; p = 0.031), larger tumor size (OR 1.05, 95% CI 1.01–1.10; p = 0.035), and female sex (OR 3.25, 95% CI 1.10–9.59; p = 0.033) were significantly associated with detrusor muscle sampling in patients with urothelial carcinoma.
Conclusions
There was a trend towards a superior detrusor muscle sampling rate after bipolar TURBT. Further studies are needed to determine its implications on disease recurrence and progression.
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Acknowledgements
The authors would like to thank Ms. Lam Nga-Yee, Ms. Luke Yip, and Mr. Leung Chi-Ho for their assistance in patient recruitment, data collection, and analysis process.
Conflict of interest
Jeremy Yuen-Chun Teoh, Eddie Shu-Yin Chan, Siu-Ying Yip, Ho-Man Tam, Peter Ka-Fung Chiu, Chi-Hang Yee, Hon-Ming Wong, Chi-Kwok Chan, Simon See-Ming Hou, and Chi-Fai Ng have no conflicts of interest to declare.
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Teoh, J.YC., Chan, E.SY., Yip, SY. et al. Comparison of Detrusor Muscle Sampling Rate in Monopolar and Bipolar Transurethral Resection of Bladder Tumor: A Randomized Trial. Ann Surg Oncol 24, 1428–1434 (2017). https://doi.org/10.1245/s10434-016-5700-7
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DOI: https://doi.org/10.1245/s10434-016-5700-7