Three months’ recurrence rate of non-muscle invasive bladder carcinoma based on surgeon experience as a single variant

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Abstract Introduction: Transurethral resection of the bladder tumor (TURBT) followed by intravesical instillation therapy (based on risk stratification) is the standard treatment for non-muscle invasive bladder cancer (NMIBC). One of the factors that may affect the risk of recurrence after TURBT is the quality of surgery that may vary between individual surgeons. Objectives: The aim of the study is to evaluate the three months’ recurrence rate of NMIBC based on surgeon experience. Methodology: The study is a double blinded prospective randomized study conducted on 50 patients with NMIBC who underwent TURBT. All Treatment-naive patients with suspected NMIBC candidate for TURBT were included, with exclusion of patients with previous history of TURBT, previous open bladder surgery, patients with urethral stricture and patients with muscle invasive bladder cancer. Patients were divided into two groups; Group A included 25 patients who underwent TURBT by a senior surgeon (more than 5 years’ experience), and Group B included 25 patients underwent TURBT by a qualified junior surgeon (less than 5 years’ experience). All patients underwent follow up cystoscopy by another senior surgeon (who was blinded to the name of the first surgeon) at three months. Results: No statistically significant difference was found between both groups regarding the incidence of urethral injury, bladder perforation, ureteric injury, obturator reflex, and bleeding. Group B showed a statistically significant longer operative time, postoperative irrigation time, more hemoglobin loss, longer hospital stay, and higher 3 months’ recurrence rates. Moreover, senior surgeons’ specimens were more likely to include detrusor muscles. Conclusion: A surgeon’s experience may have a significant impact on the quality of TURBT and risk of recurrence after TURBT for NMIBC.

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