( The comparison between transurethral resection of bladder tumor (TURB) and electrovaporization (TUVB) in terms of complications in Treatment of bladder tumor bigger than 2 cm)

Abstract

* The importance and justification of the research:

The importance of this study comes in proving the importance and effectiveness of transurethral vaporization of bladder tumors due to the benefits and advantages it provides, including better hemostasis, thus reducing the need for blood transfusion, reducing the recovery period, avoiding bladder perforation, reducing the volume of irrigation fluids, and a quick recovery time. Electrical vaporization of bladder tumors is characterized by reducing the high cost and complications associated with electrosurgical curettage treatment on the one hand, and the possibility of treating high-risk patients, especially those who take anticoagulant medications, on the other hand.

* The Aim:

Comparison between transurethral curettage of bladder tumors (TURB) and electrical vaporization of bladder tumors (TUVB) for the treatment of bladder tumors larger than 2 cm in terms of complications (bleeding, perforation, and TUR syndrome) at Tishreen University Hospital in the period 2022-2023.

* Patients and methods:

Study type: Randomized Clinical Trail Study (Prospective)1- Description StatisticalExpressing quantitative variables with measures of central tendency and measures of dispersion, and qualitative variables with frequencies and percentages.2- Inferential Statistical based on the laws of statisticsIndependent T student test to compare the means of two independent groups.Chi-square test to study the relationship between qualitative variables.The results are considered statistically significant with a p-value >0.05.Adopting the IBM SPSS statistics (Version20) program to calculate statistical coefficients and analyze the results.

• The research sample included 150 patients who were admitted to the Urology Department with a history of a bladder tumor at Tishreen University Hospital in Latakia during the time period extending between the years 2022-2023. Of them, 53 patients were excluded who had a bladder tumor smaller than 2 cm and did not meet the inclusion criteria. Of them, 97 patients were studied.The first group: Transurethral curettage of bladder tumors included 64 patients (65.9%).The second group: electrical vaporization of bladder tumors included 33 patients (34.1%). *Results:1_The incidence of bleeding that required a blood transfusion in electro-fumigation patients was (0%), while it was (14%) in curettage patients, where there was a significant statistical difference, as the value was:P-value=0.003 2_ The incidence of bladder perforation in electro-vaporization patients was (0%), while it was (7%) in curettage patients, where there was a significant statistical difference, as the value was:P-value=0.043_ As for curettage syndrome (TUR), it is a rare syndrome and has not been observed to occur during the surgical procedure, whether with curettage or electrical vaporization techniques.4_The results also show that the length of stay of the urinary catheter in fumigation patients ranged between (2-3) days, while in curettage patients it was between (4-6) days, with a statistically significant difference, as the P-value was 0.0001. The recovery period for fumigation patients after surgery was between (1-2) days, while for curettage patients it was between (2-4) days, with a statistically significant difference, as the P-value = 0.0001.When discussing the previous results, it becomes clear that postoperative complications in patients treated with the electrovaporation technique (TUVB) are significantly less than those in patients treated with the electrovaporization technique (TURB).The study confirms that the electrical fumigation technique is a safe and effective surgical technique with few complications, a lower economic cost, and a shorter recovery period than the electrical curettage technique. 

*Recommendations and Suggestions:

It is recommended to use the electrical vaporization technique in the treatment of bladder tumors, as the electrical vaporization technique is characterized as a safe and effective technique in the treatment of bladder tumors. This technique provides a clear view of the surgical area, and this helps in avoiding complications and removing all tumor foci.

Electrovaporization reduces the length of stay of the urinary catheter and the duration of postoperative hospitalization and thus reduces the economic cost.