Mp35-12 Eligible Parameters to Predict Early Post Operative Haematuria in Patients With Bladder Cancer Undergoing Turbt

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation II (MP35)1 May 2024MP35-12 ELIGIBLE PARAMETERS TO PREDICT EARLY POST OPERATIVE HAEMATURIA IN PATIENTS WITH BLADDER CANCER UNDERGOING TURBT Onofrio Antonio Rera, Andrea Fuschi, Yazan Al Salhi, Paolo Pietro Suraci, Silvio Scalzo, Alice Antonioni, Fabio Maria Valenzi, Manfredi Bruno Sequi, Damiano Graziani, Filippo Gianfrancesco, Giorgio Martino, Giuseppe Candita, Alessandro Sciarra, Cosimo De Nunzio, Ettore De Bernardinis, Antonio Cicione, Antonio Luigi Pastore, and Antonio Carbone Onofrio Antonio ReraOnofrio Antonio Rera , Andrea FuschiAndrea Fuschi , Yazan Al SalhiYazan Al Salhi , Paolo Pietro SuraciPaolo Pietro Suraci , Silvio ScalzoSilvio Scalzo , Alice AntonioniAlice Antonioni , Fabio Maria ValenziFabio Maria Valenzi , Manfredi Bruno SequiManfredi Bruno Sequi , Damiano GrazianiDamiano Graziani , Filippo GianfrancescoFilippo Gianfrancesco , Giorgio MartinoGiorgio Martino , Giuseppe CanditaGiuseppe Candita , Alessandro SciarraAlessandro Sciarra , Cosimo De NunzioCosimo De Nunzio , Ettore De BernardinisEttore De Bernardinis , Antonio CicioneAntonio Cicione , Antonio Luigi PastoreAntonio Luigi Pastore , and Antonio CarboneAntonio Carbone View All Author Informationhttps://doi.org/10.1097/01.JU.0001009372.61513.54.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Complication rates after TURBT are approximately 4–6% of which urinary tract infections and significant haematuria are most common. The aim of the study is to find valid criteria and to validate a scoring nomogram that significantly may predict the risk of post-operative(PO) haematuria in patients undergoing TURBT for bladder cancer. METHODS: The variables examined were sex, age, BMI, number of lesions and largest lesion diameter, type of tumour bed, pre-operative Hb, use of anticoagulant drugs, smoking habits, relapse, occupational risk factors, familiarity, American Society of Anaesthesiologist (ASA) classification, need for PO intensive care. Surgery was performed under general or spinal anaesthesia with one-shot antibiotic EV prophylaxis. All procedures were performed with bipolar energy. The association between complications and major risk factors have been investigated through a series of univariate and multivariate logistic regression models according to the appearance of complications requiring hospital management. RESULTS: We examined retrospectively 830 pts. Mean age was 62 (51-83 years) with a slight prevalence of male gender (55%). Mean surgical time was 40.6 min (15-62 min). On univariate Cox regression analysis, age was significantly associated with the risk of developing PO haematuria (≥70 y.o.; p<0,0001). The number of lesions (>2), the size (≥3 cm) and the tumour bed (large diameter) represented a further significant risk factor (p<0,0001), as the probability of complications increased proportionally to the number and size of lesions (p<0,0001). Use of anticoagulant drugs and pre-operative Hb (<10 g/dL) were significant risk factors (p<0,0001). On multivariate Cox regression, all these variables were independent predictors of PO hematuria within 24-48h. From these results, we developed a score comprising all significant variables, assigning to each variable a score from 0 to 2. We created a nomogram to predict the risk of PO haematuria at 24-48h (classifiable as Clavien-Dindo >2) to ensure optimal perioperative pts management. A statistically significant correlation has been found between the score (cut-off >5) and the risk of early PO haematuria (r+0,711; p<0,0001). CONCLUSIONS: Considering the prevalence of patients undergoing TURBT, the use of carefully selected pre-operative criteria may predict the risk of re-admission and re-intervention. Our scoring system resulted statistically significant to predict early PO haematuria and to program better perioperative management in pts with higher PO bleeding risk. Source of Funding: D'Andrea D., Soria F., Hurle R., Enikeev D., Kotov S., Régnier S., Xylinas E., Lusuardi L., Heidenreich A., Cai C., Frego N., Taraktin M., Ryabov M., Gontero P., Compérat E., Shariat SF; eBLOC Study Team. En Bloc Versus Conventional Resection of Primary Bladder Tumor (eBLOC): A Prospective, Multicenter, Open-label, Phase 3 Randomized Controlled Trial. Eur Urol Oncol. 2023 Oct;6(5):508-515. doi: 10.1016/j.euo.2023.07.010. Epub 2023 Aug 4. PMID: 37543464 © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e585 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Onofrio Antonio Rera More articles by this author Andrea Fuschi More articles by this author Yazan Al Salhi More articles by this author Paolo Pietro Suraci More articles by this author Silvio Scalzo More articles by this author Alice Antonioni More articles by this author Fabio Maria Valenzi More articles by this author Manfredi Bruno Sequi More articles by this author Damiano Graziani More articles by this author Filippo Gianfrancesco More articles by this author Giorgio Martino More articles by this author Giuseppe Candita More articles by this author Alessandro Sciarra More articles by this author Cosimo De Nunzio More articles by this author Ettore De Bernardinis More articles by this author Antonio Cicione More articles by this author Antonio Luigi Pastore More articles by this author Antonio Carbone More articles by this author Expand All Advertisement PDF downloadLoading ...