Comparative study of histological changes (thermal artefacts) in resected specimens of monopolar and bipolar trans-urethral resection of bladder tumours

Abstract

Objective The primary aim of the study was to study the histological changes (Thermal artefacts) noted in the resected specimens between the Monopolar and Bipolar Trans-Urethral Resection of Bladder Tumours (TURBT). Patients and Methods The study was done between March 2012 and Feb 2013. This was a comparative study between Monopolar and Bipolar resection specimens studied for histological changes (Thermal artefacts). Institutional Ethics Committee approval was obtained. Informed consent was taken from all patients. Patients were randomized into two groups, Monopolar Group or Bipolar Group of 50 each to undergo TURBT. Patients either underwent Monopolar or Bipolar TURBT in Glycine and Saline respectively. Results Thermal artefacts were graded according to WHO (World Health Organization) grading system. There was no difficulty noticed during histo-pathological examination of resected specimens. In Monopolar group, there were 27 (54%) grade 2 thermal damage, 17 (34%) grade 1 thermal damage and no grade-3 thermal damage in examined specimen. In Bipolar group, there were 07 (14%) grade 2 thermal damage, 12 (24%) grade 1 thermal damage and no grade 3 thermal damage in examined specimen. Conclusion The degree of thermal damage is much lesser in histological sections of specimen resected using Bipolar energy and interpretation of the grade is easier which is one of the most important prognosticators especially in bladder tumours since high grade lesions are proven beyond doubt to progress and recur.