Association of energy source with outcomes in en bloc TURB: secondary analysis of a randomized trial

• DOI: 10.1007/s00345-025-05565-w
• Publication Date: 2025-03-30T06:00:05Z
• Authors: Stefano Mancon; Francesco Soria; Rodolfo Hurle; Dmitry Enikeev; Evanguelos Xylinas; Lukas Lusuardi; Axel Heidenreich; Paolo Gontero; Eva Compérat; Shahrokh F. Shariat; David D’Andrea
• Keywords: Nephrology

Abstract Purpose To comprehensively evaluate the efficacy of different energy sources used for en-bloc transurethral resection bladder tumors (ERBT) on perioperative outcomes. Methods This sub-analysis derived from a prospective randomized study that enrolled patients undergoing ERBT vs conventional (cTURB) January 2019 to 2022 (NCT03718754). Endpoints were pathological specimen quality and outcomes after either monopolar (m-ERBT) or bipolar (b-ERBT) laser (l-ERBT) ERBT. Results 237 resected in 188 included analyses: 29 (12.2%) m-ERBT, 136 (57.4%) b-ERBT 72 (30.4%) l-ERBT. Detrusor muscle (DM) was detected 191 (80.6%) specimens. Per-tumor analysis revealed comparable rate DM specimens obtained via modalities (p = 0.7). Operative time longer l-ERBT cohort compared m-ERBT 0.02) no obturator nerve reflex (ONR) onset reported. On logistic regression analysis, associated with negative lateral margins (OR 2.81; 95% CI 1.02–7.70; p 0.04). There significant association technique perforation conversion rates (all > 0.05). Within median follow up 22mo (IQR 11–29), total 35 (18.6%) had local recurrence. Cox less likely have recurrence (HR 0.34; 0.15–0.78; 0.01); When adjusting established confounders, this confirmed 0.24; 0.10–0.60; 0.002). Conclusions Different might achieve Further perspectives involve assessment long-term differential oncological various modalities.