Bipolar plasma kinetic enucleation of non-muscle-invasive bladder cancer: Initial experience with a novel technique

OBJECTIVE: To assess the effectiveness and safety of bipolar plasma kinetic energy for en bloc enucleation of non-muscle-invasive bladder cancer (NMIBC). PATIENTS AND METHODS: In all, 46 patients diagnosed with suspected NMIBC were included. All patients were diagnosed using ultrasonography, computed tomography, and diagnostic cystoscopy, and then underwent bipolar plasma kinetic enucleation of bladder tumour (PKEBT). At the end of the procedure, all patients had a single-dose (40 mg in 40 mL saline) intravesical installation of mitomycin C (<6 h after bipolar PKEBT). Follow-up diagnostic cystoscopy was performed at 3, 6, and 12 months. RESULTS: The mean (SD) enucleation time was 17 (5.4) min, operative time was 27.9 (11.4) min, haemoglobin drop was 1.3 (0.9) g/dL, postoperative irrigation time was 1.7 (2.3) h, and hospital stay was 35.4 (13) h. There was intraoperative bleeding in three patients, with one requiring blood transfusion. There were no other perioperative complications. At the 1-month follow-up, six (13%) patients were diagnosed with residual tumour and underwent repeat bipolar PKEBT. The overall recurrence rate at 12 months’ follow-up was 15.2%. CONCLUSION: Bipolar PKEBT is an effective procedure for managing NMIBC, as it preserves the entire lamina propria and detrusor muscle in well-intact specimens, with negligible perioperative complications.