Bipolar Versus Monopolar Transurethral Resection of Nonmuscle-Invasive Bladder Cancer: A Meta-Analysis

Bipolar energy has recently been used as a common alternative to conventional monopolar transurethral resection of the bladder (TURB) while managing nonmuscle-invasive bladder cancer (NMIBC). We established a meta-analysis comparing the safety and efficacy of plasmakinetic bipolar and monopolar TURB for NMIBC.

A systematic search of PubMed, MEDLINE, Web of Science, and China National Knowledge Infrastructure was performed up to March 1, 2015. Outcomes of interest assessing the two techniques included demographic and clinical baseline characteristics, perioperative variables, and complications.

Eight eligible trials evaluating bipolar TURB (bTURB) versus monopolar TURB (mTURB) for NMIBC were identified including six randomized controlled trials (RCTs), one prospective study, and one retrospective study. The bTURB was associated with shorter operative time (P = 0.002), shorter hospital stay (P < 0.001), less established blood loss (P < 0.001), and shorter catheterization time (P = 0.004). There were fewer complications such as obturator nerve reflex (P < 0.001) and bladder perforation (P = 0.003) in the bTURB group. The postoperative recurrence rate in 2 years also showed advantages of bTURB over mTURB.

Our data showed that bTURB appeared to be a safe and efficient method and had presented several advantages when compared with conventional mTURB in the management of NMIBC. As a promising technique, bTURB may be used as a preferable choice instead of mTURB for superficial bladder tumor.