Abstract:
PURPOSE:To evaluate prospectively the actual bladder perforation incidence during transurethral resection of bladder tumor (TURB) performed by residents and to identify possible predisposing factors to such condition. PATIENTS AND METHODS:Thirty-four patients with bladder tumor were submitted to TURB in our academic institution in April 2006, and were prospectively studied. Procedures were all done by senior residents under an attending direct supervision. All patients had a cystograms performed after the procedure by the injection of 400 mL of saline-diluted contrast solution with low-pressure infusion through the Foley catheter. The cystograms were evaluated blindly by a single radiologist. All patients were examined by cystoscopy and/or CT every 3 months for the first 2 years postoperatively. RESULTS:The cystogram showed contrast leaking compatible with bladder perforation in 17 (50%) cases. None of the perforations were recognized intraoperatively by the surgeon. All perforations were extraperitoneal and managed conservatively. There was no significant correlation between the incidence of bladder perforation and the patient age (p = 0.508), the tumor stage (p = 0.998), the tumor grade (p = 0.833), the number of lesions (p = 0.394), and the tumor size (p = 0.651). The only factor that had impact on the development of bladder perforation was tumor localization at the bottom of the bladder (p = 0.035; OR, 6750; 95% CI, 1.14, 39.8). CONCLUSION:Asymptomatic perforations of the bladder wall occur very frequently after a TURB procedure performed by residents in training and, most of the time, are not noticed by the surgeon. Localization of the tumor at bladder dome was the only factor that negatively influenced perforation rates.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
El Hayek OR,Coelho RF,Dall'oglio MF,Murta CB,Ribeiro Filho LA,Nunes RL,Chade D,Menezes M,Srougi Mdoi
10.1089/end.2008.0406subject
Has Abstractpub_date
2009-07-01 00:00:00pages
1183-6issue
7eissn
0892-7790issn
1557-900Xjournal_volume
23pub_type
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journal_title:Journal of endourology
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journal_title:Journal of endourology
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pub_type: 临床试验,杂志文章
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277902760102785
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pub_type: 传,历史文章,杂志文章
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journal_title:Journal of endourology
pub_type: 杂志文章,评审
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pub_type: 杂志文章
doi:10.1089/end.2007.0300
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journal_title:Journal of endourology
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journal_title:Journal of endourology
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journal_title:Journal of endourology
pub_type: 杂志文章
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更新日期:2012-04-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
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更新日期:2010-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:2012-10-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2018-01-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2009.0557
更新日期:2010-10-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
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更新日期:2014-05-01 00:00:00