Preoperative bladder artery embolization before transurethral resection of large bladder tumors: a propensity score–matched retrospective cohort study

Abstract Background Transurethral resection of bladder tumor (TURBT) can be technically challenging in patients with large bladder tumors because intraoperative bleeding may obscure the surgical field, prolong the procedure, and hinder complete tumor resection. Preoperative bladder artery embolization may reduce tumor vascularity and facilitate subsequent TURBT; however, comparative evidence regarding its perioperative benefits and safety remains limited. This study evaluated the perioperative outcomes of preoperative bladder artery embolization followed by TURBT within 24 h in patients with bladder tumors measuring ≥ 3 cm. Results Among 75 eligible patients, 27 underwent preoperative bladder artery embolization followed by TURBT and 48 underwent TURBT alone. Propensity score matching generated 17 matched pairs. Compared with the TURBT-alone group, the embolization group had significantly lower intraoperative blood loss (68.03 [56.68, 75.50] mL vs. 101.96 [93.62, 116.67] mL, P = 0.005) and shorter operation time (60.00 [49.00, 67.00] min vs. 80.00 [75.00, 87.00] min, P = 0.009). Postoperative hospital stay (7 [7, 8] days vs. 8 [8, 10] days, P = 0.035) and catheterization time (6 [6, 7] days vs. 8 [7, 8] days, P = 0.009) were also shorter in the embolization plus sequential TURBT group. Conclusions For bladder tumors measuring ≥ 3 cm, bladder artery embolization followed by sequential TURBT within 24 h may reduce intraoperative blood loss, shorten operation time, and promote early postoperative recovery.