Denudation of bladder mucos by needle electrode in the treatment of superficial peri-ureteral orifice bladder tumors
Li Jianchang1,2,Zhang Lingjun3,Sun Shengkun1,Xu Axiang1,Yang Guoqiang1,Xu Yong1,Chen Guangfu1,Fu Weijun1,Zhang Xu1
1Department of Urology, Chinese PLA General Hospital, Beijing 100853, China; 2Department of Urinary Surgery, Affiliated Hospital of Guangdong Medical College; 3Department of Outpatient, General Headquarters of Armed police
Abstract：Objective:To investigate the feasibility and effect of mucosa denudation during transurethral needle electrode resection of bladder tumor (TUNER-BT) in the treatment of superficial peri-ureteral orifice bladder tumors. Methods:5 patients with bladder tumors located 1 cm peri-ureteral orifice were included. The patients received epidural anesthesia. After electrocautery of the normal bladder mucosa 1 cm away from the tumor by coagulation current, the needle tip was inserted into the submucosa layer and the bladder tumor as well as the mucosa was stripped en bloc. The operation time, obturator nerve reflex, peri-operative complications, and pathologic stage of the tumors were observed. Results:5 peri-ureteral orifice bladder tumors were resected with the operative time of 5-15 min per tumor (range, 7.8±6.2 min). Obturator nerve blockade is not necessary in any case and no obturator nerve reflex occurred. Peri-operative blood loss was minimal. The urine drainage retained 24-48 h. The pathologic stage of tumors showed 4 in Ta,and 1 in T1. No tumor recurrence and no complications such as stricture of uretero-vesical orifice, hydronephrosis or vesicoureteral reflux occurred during a follow-up of 3-6 months. Conclusions:Denudation of the bladder mucosa by TUNER-BT is a simple and reliable method during treatment of superficial bladder tumors located near the ureteral orifice. However, the long-term oncologic outcomes remain to be defined.
