Impact of Conventional and En- Bloc Transuerthral Resection of Bladder Tumors on Operative and Pathological Outcomes in Newly Diagnosed Cases

This prospective study aimed to compare the outcomes of conventional transurethral resection of bladder tumor (cTURBT) and en bloc TURBT (eTURBT) in patients with newly diagnosed bladder tumors. A total of 200 patients treated at Alexandria University Hospital from January 2022 to January 2024 were included. Patients were allocated to either cTURBT (n=137) or eTURBT (n=63) based on tumor characteristics such as size, number, and location. Both techniques utilized monopolar or bipolar electrocautery under white light and were performed by experienced urologists.The mean patient age was 61 years, with a male-to-female ratio of 3:1. Tumor size was significantly smaller in the eTURBT group (2.47 cm vs 3.04 cm, p=0.01). Although the detection of muscularis propria was higher in eTURBT (95.2%) than cTURBT (89.9%), the difference was not statistically significant (p=0.199). Both groups had similar rates of T1 high-grade tumors.eTURBT demonstrated several advantages over cTURBT: shorter operative time (45.2 vs 52.2 minutes, p=0.004), less hemoglobin drop (0.62 vs 0.82 g/dL, p=0.03), no transfusion requirement, and no bladder perforations. Catheterization duration and hospital stay were also shorter in the eTURBT group (p=0.01 and p=0.02, respectively). The incidence of obturator jerk was similar between groups.In conclusion, eTURBT is associated with improved operative efficiency, reduced complication rates, and better pathological assessment, suggesting it may be a superior technique to conventional TURBT in the management of bladder tumors.