Unveiling the risks: Navigating operative and Post-Operative complications in Transurethral Resection of Bladder Tumor.

Abstract

Background: Transurethral Resection of Bladder Tumor (TURBT) is a cornerstone in the management of non-muscle invasive bladder cancer, yet it poses inherent risks such as bleeding, perforation, electrolyte imbalances, and urinary tract infections (UTIs). Effective intraoperative management is crucial to minimize these risks and optimize patient outcomes. This study aimed to elucidate the spectrum of early complications following TURBT.

Methodology: A descriptive study involving 98 patients was conducted using non-probability consecutive sampling at the Department of Urology, Sindh Institute of Urology and Transplantation (SIUT), over a period of 6 months (February 22, 2022 - August 24, 2022). TURBT procedures were performed under general anesthesia, with patients admitted 24 hours preoperatively and discharged within 48 hours. Follow-up evaluations were scheduled at 1 week and 4 weeks post-resection to document complications.

Results: The study included 98 patients undergoing TURBT. Postoperative complications observed at the first week included increased rates of gross hematuria (20 patients), blood transfusions (7 patients), symptomatic urinary tract infections (3 patients), and acute kidney injury (3 patients). By the fourth week, complications had generally decreased, but persistent issues included urinary tract infections (10 patients), fever (10 patients), and acute kidney injury (4 patients). The duration of the procedure and tumor size significantly influenced complication rates, with longer procedures and larger tumors associated with higher incidences of fever, urinary tract infections, and acute kidney injury.

Conclusion: The study highlights that longer TURBT procedures and larger tumor sizes are associated with increased postoperative complications, including fever, urinary tract infections, and acute kidney injury. Effective management strategies and early detection of bladder cancer may help reduce these complications.