[The complications of transurethral resection of the bladder for tumor]

Transurethral resection (TUR) is now widely used in combined treatment of urinary bladder cancer, but the procedure may be compromised if applied without evaluation of infiltration and malignancy degree and metastases responsible for frequent recurrences. The aim of this study was design of effective measures to prevent TUR complications. For 8 years the surgeons from the Moscow Medical Academy urological clinic made 824 TURs for bladder tumors in 322 patients (mean age 57.5 years, 72.6% of males, 27.4% of females). At the stage T3-4 TUR was conducted in contraindications to cystectomy or absence of distant metastases. The following intra- or postoperative complications were observed: hemorrhages (4.6%), intraperitoneal perforations (0.3%), extraperitoneal perforations (0.9%), vesicoureteral reflux (2.8%), enuresis (1.2%). The emergence and severity of the complications were dependent on the bladder tumor stage and degree of infiltration of the muscular layer. Positive TUR results are more feasible in more strict approach to the indications for surgery, adequate surgical skills and technique, high-quality anesthesia, early arrest of hemorrhage, low pressure of the washing liquid in the course of operation.