Monopolar versus Bipolar Transurethral Resection of Non-Muscle Invasive Bladder Cancer

Background: Recently, the bipolar current has been used as an alternative technique to conventional monopolar current which was used traditionally in trans-urethral resection of bladder tumor [TURBT].The aim of the work: To evaluate the safety and efficacy of monopolar versus bipolar TURBT in the management of primary non-muscle-invasive bladder cancer [NMIBC].Patients and Methods: This prospective study was conducted on 80 patients [70 males and 10 females] aged 36 years or older, presented with primary bladder mass from March 2016 to March 2020 at the Urology Department of Al-Zahraa University Hospital. Patients were classified randomly into two groups: group [A] included 40 patients who had M-polar TURBT, and group [B] included 40 patients who had B-polar TURBT. The main studied outcomes were the frequency of intraoperative and postoperative complications, as well as the rate of recurrence after 12 months of follow-up.Results: There was no statistical difference between the two groups regarding demographic data of patients and characters of the tumor. Intra-operatively, there was a significant difference between both groups regarding obturator reflex, which was higher in M-polar TURBT group than B-polar TURBT group [25% vs. 5%; P= 0.013] respectively. Operative time was shorter in the B-polar TURBT group than M-polar TURBT, but with no statistically significant difference. There was a mild drop in hemoglobin & hematocrit value in M-polar TURBT than the B-polar TURBT, but with no statistically significant difference. There was no significant difference in the recurrence rate of both groups after one year of follow-up.Conclusion: Our study revealed that B-polar TURBT is more safe and effective in the management of primary bladder tumors.