Comparison of Presence of Detrusor Muscle in Pathology Between Monopolar Conventional TURBT and En-Bloc TURBT

Introduction: According to EAU 2018 guidelines, TURBT is the gold standard method for diagnosis and treatment of non-muscle invasive bladder tumor. It has been reported that in 50% of cases no detrusor was found in the specimen. The aim of this study is to compare presence of detrusor in specimens taken by conventional and en-bloc method. Methods: From September 2017 to September 2018, 60 patients with solitary papillary tumor sized less than 3 cm, and no prior history of bladder cancer, randomly divided into two groups: Conventional TURBT and en-bloc TURBT with monopolar hook. Mean operation time, perforation rate, and presence of detrusor muscle were compared between two groups. Results: Mean operation time in en-bloc TURBT was 15.46 ± 3.52 minutes and in conventional TURBT was 20.6 ± 5.04 minutes. The mean operation time was significantly different between the two groups. No clinical bladder perforation was seen in the two groups. In 28 cases (93.3%) of en-bloc group the detrusor was seen in pathologic reports while presence of detrusor in pathology report was positive in 25 cases (83.3%) of the conventional group, this difference was not statistically significant. Conclusions: En-bloc TURBT with monopolar hook was as effective as conventional method with no increase in bladder perforation, and due to lower operation time it is a better option than conventional TURBT.