Transurethral Resection of Bladder Tumor - Novel Techniques in a New Era

Sep 24, 2026

Uploaded by Bulrr

Transurethral resection of bladder tumor (TURBT) supports both diagnosis and treatment for bladder cancer, but outcomes vary with multiple influencing factors. En-bloc resection of bladder tumors (ERBT) is presented as a primary approach for most non-muscle-invasive bladder cancers, while comparative evidence on energy source superiority remains inconclusive. The text contrasts laser, needle-shaped electrodes, improved cystoscopy, and large-channel systems for super TURBT and pneumocystoscopy-based partial cystectomy, aiming to improve precision and reduce complications and recurrence.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Abstract

Introduction

Background on NMIBC and TURBT

En-bloc Resection

ERBT provides high-quality specimen

Transurethral Resection of Bladder Tumor: Novel Techniques in a New Era Shengkun Sun†, Hengen Wang†, Xu Zhang ,Guangfu Chen* Department of Urology, Chinese PLA General Hospital †These authors contributed equally to this work. *Corresponding author: Guangfu Chen: [chenguangfu@301hospital.com.cn](chenguangfu@301hospital.com.cn)[ ](chenguangfu@301hospital.com.cn)[Conflict of interest:](Conflict of interest: The authors declared no conflict of interest.)[ The authors declared no conflict of interest.](Conflict of interest: The authors declared no conflict of interest.) Abbreviation used: TURBT: transurethral resection of bladder tumor; ERBT: en-bloc resection of bladder tumors; NMIBC: non-muscle-invasive bladder cancer; ONR: obturator nerve reflex; WLC: white light cystoscopy; BLC: blue light cystoscopy; NBI: narrow-band imaging; PDI: photodynamic imaging; PC: partial cystectomy; MIBC: muscle-invasive bladder cancer; S-scope: super scope; STURBT: super transurethral resection of bladder tumor Received September 19, 2023; Revision received October 10, 2023; Accepted October 11, 2023; Published November 9, 2023 ABSTRACT Transurethral resection of bladder tumor (TURBT) serves both diagnostic and therapeutic purposes in the management of bladder cancer. Attaining a high-quality TURBT is not always guaranteed due to various factors. En-bloc resection of bladder tumors (ERBT) holds promise to be a primary technique for removing bladder tumors in most non-muscle invasive bladder cancers. However, so far, no conclusive evidence indicates the superiority of any specific energy source used for ERBT. While laser energy can prevent the activation of obturator nerve reflex during ERBT, it poses challenges such as thermal injury and imprecise controllability. Needle-shaped electrodes offer high-level precision and controllability, without causing tissue deterioration or vaporization. The primary limitation of ERBT at present is the extraction/harvesting of large en-bloc specimens. Effective tools have been developed to overcome this limitation. Enhanced cystoscopy improves the detection of flat and small bladder tumors, allowing for better removal of cancerous tissues and significantly reducing recurrence rates. Advances in medical technology have brought forth a multitude of strategies to address the shortcomings of traditional TURBT. Appliances with large operating channel provide a platform for conducting laparoscopic procedures within the context of pneumocystoscopy, facilitating the execution of super TURBT and conferring comparable advantages to en-bloc resection. Moreover, the utilization of pneumocystoscopy enables the safe and effective performance of transurethral partial cystectomy for localized muscle-invasive bladder cancer. Novel techniques significantly improve the precision of the transurethral surgery and lower the risk of complications. Keywords: transurethral resection of bladder tumor, bladder cancer, super TURBT, partial cystectomy Bladder cancer represents one of the most prevalent cancers across the globe. Approximately, 75% of the cases fall into the category of non-muscle-invasive bladder cancer (NMIBC), which encompasses Ta, T1, and Tis (tumor in situ) [1] . The standard treatment for NMIBC is transurethral resection of bladder tumors (TURBT) plus adjuvant intravesical chemotherapy [2] . TURBT, which employs a wire loop, is regarded as the cornerstone and gold standard for staging and treating NMIBC since the 1910s [3]. Nevertheless, the piecemeal resection, the potential scattering of tumor cells, and the absence of detrusor muscle in the resected specimen are believed to be drawbacks of the conventional TURBT [4,5]. This resection technique isnot inline with the fundamental principles of oncological surgery, i.e., efficient diagnosis and treatment of bladder cancer. In recent years, advances in medical technologies, including surgical techniques and instruments, micro or small tumor imaging, hav

FAQs

What are TURBT and ERBT used for in bladder cancer management?

TURBT is used for both diagnostic staging and therapeutic resection. ERBT is discussed as a technique for primary removal of tumors in most non-muscle-invasive bladder cancers.

Why is high-quality TURBT not always guaranteed?

The text attributes variability to multiple factors affecting resection quality. It also highlights limitations of conventional piecemeal resection such as potential tumor cell scattering and specimen issues.

What main limitations and solution strategies for ERBT are discussed?

A key limitation is the extraction/harvesting of large en-bloc specimens. The document describes effective tools and complementary technologies, including enhanced cystoscopy and equipment enabling super TURBT and pneumocystoscopy-guided partial cystectomy.

Sep 24, 2026

Uploaded by Bulrr