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The following is a summary of “Association of energy source with outcomes in en bloc TURB: secondary analysis of a randomized trial,” published in the March 2025 issue of World Journal of Urology by Mancon et al. 

Researchers conducted a prospective study to evaluate the efficacy of different energy sources for en-bloc transurethral resection of bladder tumors (ERBT) on perioperative outcomes.  

They analyzed a sub-analysis of a prospective randomized study enrolling patients undergoing ERBT vs. conventional transurethral resection of the bladder (cTURB) from January 2019 to January 2022 (NCT03718754), assessing pathological specimen quality and perioperative outcomes for monopolar (m-ERBT), bipolar (b-ERBT), or laser (l-ERBT) ERBT. 

The results showed 237 bladder tumors resected in 188 patients: 29 (12.2%) m-ERBT, 136 (57.4%) b-ERBT, and 72 (30.4%) l-ERBT. Detrusor muscle (DM) was detected in 191 (80.6%) specimens, with comparable rates across energy modalities (P=0.7). Operative time was longer in l-ERBT vs. m-ERBT and b-ERBT (P=0.02), and no obturator nerve reflex (ONR) onset occurred. b-ERBT was linked to negative lateral margins (OR 2.81; 95% CI 1.02–7.70; P=0.04), with no significant differences in perforation or conversion rates (all P>0.05). At a median 22-month follow-up (IQR 11–29), 35 (18.6%) patients had local recurrence, with b-ERBT reducing recurrence risk (HR 0.34; 95% CI 0.15–0.78; P=0.01), confirmed after adjustment (HR 0.24; 95% CI 0.10–0.60; P=0.002). 

Investigators found that different energy sources achieved comparable perioperative outcomes. Further assessment of long-term oncological outcomes was needed. 

Source: link.springer.com/article/10.1007/s00345-025-05565-w