Bipolar versus monopolar transurethral resection of non-muscle-invasive bladder cancer: a systematic review and meta-analysis of randomized controlled trials

Purpose To compare the efficacy and safety of bipolar and monopolar transurethral resection of bladder tumors (TURBT) in non-muscle invasive bladder cancer (NMIBC) treatment. Methods A systematic search of all Randomized Controlled Trials (RCTs), which compared bipolar TURBT (bTURBT) and monopolar T...

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Bibliographic Details
Published in:World journal of urology 2021-04, Vol.39 (4), p.1177-1186
Main Authors: Xie, Kexin, Cao, Dehong, Wei, Qiang, Ren, Zhengju, Li, Jinze, Li, Yunxiang, Fu, Meiling
Format: Article
Language:English
Subjects:
Bladder cancer
Catheterization
Clinical trials
Intubation
Invasiveness
Medicine
Medicine & Public Health
Meta-analysis
Nephrology
Oncology
Original Article
Safety
Statistical analysis
Tumors
Urology
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Summary:Purpose To compare the efficacy and safety of bipolar and monopolar transurethral resection of bladder tumors (TURBT) in non-muscle invasive bladder cancer (NMIBC) treatment. Methods A systematic search of all Randomized Controlled Trials (RCTs), which compared bipolar TURBT (bTURBT) and monopolar TURBT (mTURBT) in NMIBC treatment, were performed in PubMed, Web of Science, Cochrane Library and Embase up to February 1, 2019. We evaluated their efficacy by operative time, hospitalization time, catheterization time, and recurrence rate. While obturator jerk, bladder perforation, thermal damage, and overall complications were used to evaluate their safety. Results A total of 13 RCTs, involving 2379 patients, were included. There were no statistically significant differences in efficacy between bTURBT and mTURBT in NMIBC treatment, such as operative time ( p  = 0.12), hospitalization time ( p  = 0.13), catheterization time ( p  = 0.50), and recurrence rate ( p  = 0.88). Compared to the safety in mTURBT in NMIBC treatment, no significant advantages were observed in that in bTURBT as well, such as obturator jerk ( p  = 0.12), bladder perforation ( p  = 0.11), thermal damage ( p  = 0.24), and overall complications ( p  = 0.65). Conclusions Our analysis demonstrated that bTURBT has no significant advantages in efficacy and safety in NMIBC treatment compared to that in mTURBT. Thus, bTURBT could not completely replace mTURBT as a safer and more effective NMIBC treatment.
ISSN:0724-4983
1433-8726
DOI:10.1007/s00345-020-03271-3