TURis plasma vaporization in non–muscle invasive bladder cancer–the first Romanian experience with a new technique

Introduction: The development of bipolar resection using saline irrigation provided significant improvements in NMIBT treatment. The aim of our study was to evaluate the efficacy and safety of a newly introduced endoscopic technique, the bipolar transurethral resection in saline–plasma vaporization of bladder tumors (TURis–PVBT). Materials and Methods: Between May and October 2009, 57 consecutive patients presenting papillary bladder tumors larger than 1 cm underwent TURis–PVBT and a 3 months follow–up. Initial tumor biopsy, followed by plasma vaporization of the tumor and biopsies of the tumoral bed were performed in all cases. Complementary treatment was applied according to risk indications. The follow–up protocol included abdominal ultrasonography, cytology and cystoscopy at 3 months. Results: TURis–PVBT was successfully performed in all cases. Multiple tumors were found in 45.6% of the cases and 50.9% of the patients presented tumors larger than 3 cm. The mean tumoral volume was of 11 ml. The mean operative time was of 17 minutes, the mean hemoglobin decrease was of 0.4 g/dl, the mean catheterization period was of 2.5 days and the mean hospital stay was of 3.5 days. The pathological exam diagnosed 57.9% pTa cases, 31.6% pT1 cases and 10.5% pT2 cases. No tumoral base biopsies were positive for malignancy. The recurrence rate at 3 months for the 51 NMIBT patients was of 15.7%. Orthotopic recurrent tumors were encountered in 5.9% of the cases. Conclusions: TURis–PVBT seems to represent a promising endoscopic treatment alternative for NMIBT patients, with good efficacy, reduced morbidity, fast postoperative recovery and satisfactory follow–up parameters.