Open Access

ARTICLE

A randomized, controlled trial for transurethral treatment of bladder tumors using PlasmaButton vaporization electrode or monopolar loop electrocautery

Mehrdad Alemozaffar¹, Kenneth Ogan¹, Christopher P. Filson¹, Dattatraya Patil¹, Grace Lee², Daniel J. Canter³, Gordon Hong⁴, Viraj A. Master¹

1 Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA
2 Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
3 Department of Urology, Ochsner Medical Center, New Orleans, Louisiana, USA
4 Northeast Ohio Medical University, Rootstown, Ohio, USA
Address correspondence to Dr. Kenneth Ogan, Department of Urology, Emory University, 1365 Clifton Road NE, Atlanta, GA 30322 USA

Canadian Journal of Urology 2019, 26(5), 9908-9915.

Abstract

Introduction: The use of an electrocautery device (monopolar loop) for patients undergoing transurethral resection of bladder tumors (TURBT) is standard of care. The aim of this study is to establish non-inferiority of complication rates for a bipolar energy device, the PK PlasmaButton (PK Button), when compared to the monopolar loop.
Materials and methods: Seventy-eight subjects (41 monopolar loop and 37 PK Button), were enrolled in a single-center, prospective, randomized study with cystoscopically detected bladder tumors that were judged endoscopically resectable with only one trip into the operating room. Intra and postoperative data on complication rates, operative time, catheterization time, and disease recurrence rates at 3-month follow-up were collected.
Results: Overall complication rates after TURBT with the monopolar loop or PK Button were similar (56% versus 38% respectively, p = 0.107); however, there were more bladder perforations in the monopolar loop arm compared to the PK Button arm (12.2% versus 0%, respectively, p = 0.028). There was no difference in overall operative time (p = 0.170), catheterization time (p = 0.709), and disease recurrence (p = 0.199).
Conclusion: The results of this study demonstrated no difference between the monopolar loop and PK Button in regard to overall complications; however, there was a higher rate of bladder perforation with monopolar TURBT. PK Button vaporization for bladder tumors represents a promising alternative to traditional monopolar TURBT without compromising short-term (3-month) cancer recurrence rates.

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Keywords

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