The Effect of Trans-urethral Resection of the Bladder Tumour (TURBT) on Routine Haematological and Biochemical Blood Tests: A Clinical-pilot Observational Study

Abstract

Background: Bladder Cancer remains a major health burden, with over 10,000 new cases diagnosed annually in the UK. Around 80% of all cases are diagnosed as Non-Muscle Invasive Bladder Cancer (NMIBC), and 75% of patients have cancer recurrence and progression within 10 years. Patients with NMIBC are treated by Trans-Urethral Resection of the Bladder Tumour (TURBT), with approximately 8% of patients subsequently developing post-operative complications, such as bleeding, pain and infection. Currently, there is limited literature on the ‘normal’ pathophysiological response to TURBT for NMIBC, and predictors for post-operative complications. The aim of this clinical-pilot observational study was to evaluate changes in routine blood tests following TURBT. The objectives were to identify the ‘normal’ pathophysiological response after TURBT. Methods: 34 consecutive patients aged between 57–94 years (median age: 72), scheduled for TURBT were recruited after written informed consent. Venous blood samples were collected from patients pre operatively (baseline), and post operatively at the following time points; 30 minutes, 120 minutes and 240 minutes post-operatively. Results: Following TURBT, significant decreases were seen in several haematological and biochemical markers: haemoglobin (p<0.01), platelets (p<0.01), erythrocytes (p<0.01), haematocrit (p<0.01), plasma viscosity (p=0.002) activated partial thromboplastin time (p= 0.004), fibrinogen (p<0.01), potassium (p<0.01), globulin (p=0.047), alkaline phosphatase (p=0.001), and urea (p=0.001). Furthermore, significant increases were observed in numerous haematological and biochemical parameters: leukocytes (p=0.049), neutrophil count (p=0.022), prothrombin (p=0.014), bilirubin (p= 0.004), and alanine transaminase (p=0.004). Conclusion: Significant changes to several routine blood tests occur following TURBT, and in general, it appeared that the most noticeable changes occurred between 30 and 120 minutes post-operatively. This clinical-pilot study may therefore provide a sound platform to undertake larger studies, to fully establish the effect of TURBT on routine blood tests, and could ultimately provide valuable information for doctors that may help with the clinical management of patients.