An Evaluation of Monopolar and Bipolar Electrocautery in Transurethral Resection of Urinary Bladder Tumors

Background: Transurethral resection of bladder tumor (TURBT) has a role in the diagnostic evaluation and treatment of bladder cancer, which is traditionally conducted through monopolar electrocautery; however, bipolar electrocautery has gained attention these days. Cautery artifacts are known as the drawbacks of TURBT and can be seen in both monopolar and bipolar electrocautery but with varying severity. Studies comparing bipolar to monopolar TURBT have shown conflicting results. Objectives: This study was carried out to compare the occurrence of cautery artifacts and a number of important clinical outcomes between patients undergoing monopolar and bipolar electrocautery during TURBT. Methods: This prospective study included adult patients with age 18 years old or higher diagnosed with primary bladder tumors with a size ≤4 cm. The patients were randomized into monopolar and bipolar groups (34 patients per group). The occurrence of cautery artifacts, duration of surgery, the incidence of urinary bladder perforation, fall in hemoglobin, need for blood transfusion, transurethral resection syndrome, and postoperative hospital stay between the two groups. Results: In our study, the incidence of cautery artifacts was significantly lower in the bipolar group than in the monopolar group (P-value < 0.0001). The two groups were comparable in terms of the duration of surgery, urinary bladder perforation, fall in hemoglobin, need for blood transfusion, transurethral resection syndrome, and postoperative hospital stay. Conclusions: Bipolar TURBT is superior to monopolar TURBT regarding a reduction in the incidence of cautery artifacts.