Detection of Bladder Tumour Muscle Invasion: A Prospective Comparative Study of En-Bloc Versus Conventional Turbt Techniques

Objective: To compare the outcomes of En-bloc transurethral resection of bladder tumour (TURBT) with Conventional TURBT in patients with non-muscle-invasive bladder cancer. Methods: Sixty patients with bladder tumours were prospectively randomised to undergo either Conventional TURBT (n=30) or En-bloc TURBT (n=30). Baseline demographic and tumour characteristics were recorded. Primary endpoints included detrusor muscle presence, cautery artefact, perioperative complications, and early postoperative recovery. Secondary outcomes included recurrence and re-resection rates at three months. Statistical analysis was performed using chi-square and t-tests, with p<0.05 considered significant. Results: Baseline characteristics were comparable between the groups. En-bloc TURBT achieved significantly higher detrusor muscle retrieval (90.0% vs. 63.3%, p=0.018) and lower cautery artefact rates (13.3% vs. 33.3%, p=0.047). Perioperative blood loss was lower in the En-bloc group (mean haemoglobin drop 0.9 ± 0.4 g/dL vs. 1.5 ± 0.6 g/dL, p=0.002). Postoperatively, catheterisation time (2.8 ± 0.7 vs. 3.5 ± 0.9 days, p=0.004) and hospital stay (4.1 ± 1.0 vs. 5.0 ± 1.2 days, p=0.006) were significantly reduced following En-bloc resection. At three months, recurrence (6.7% vs. 20.0%, p=0.14) and re-resection rates (6.7% vs. 20.0%, p=0.12) were lower in the En-bloc group, though not statistically significant. No patient progressed to muscle-invasive disease. Conclusion: En-bloc TURBT offers superior pathological quality, reduced perioperative morbidity, and faster recovery compared to Conventional TURBT, without compromising short-term oncological outcomes. It represents a safe and effective alternative for appropriately selected patients with non-muscle-invasive bladder cancer.