Increased Plasma Ignition Distance Practice may Prevent the Obturator Reflex Occurrences and Compare of its Effectiveness Versus Obturator Block: A Prospective, Randomized, Controlled Study

• Published in: Urology (Ridgewood, N.J.) Vol. 176; pp. 226 - 231
• Main Authors: Ergün, Osman, Alperen Öztürk, Sefa, Kırçiçek, Fahrettin, Gürdal, Osman, Soyupek, Sedat, Oksay, Taylan, Özorak, Alper
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2023
• Subjects: Humans; Obturator Nerve - pathology; Prospective Studies; Reflex; Urinary Bladder - diagnostic imaging; Urinary Bladder - innervation; Urinary Bladder - surgery; Urinary Bladder Neoplasms - pathology; Urinary Bladder Neoplasms - surgery; Urologic Surgical Procedures - methods
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2023.03.003

To compare the ability of the obturator nerve block (ONB) and increased plasma ignition distance practice (IPDP) techniques to inhibit obturator nerve reflex (ONR) occurring with bipolar transurethral resection of the bladder. Sixty patients who had a tumor placed at the lateral sidewall or had a tumor in another part of the bladder along with the lateral wall were randomly enrolled. Cystoscopic and ultrasonographic examinations and a computerized tomography scanning of the urinary bladder were used to determine the ONB side. Group 1 consisted of patients who had the ONB procedure. Group 2 consisted of patients who had IPIDP. The severity of the ONR was classified as severe, mild, and very mild. The study's primary endpoint was ONR occurrences and successful completion of the surgery. The secondary endpoints were bleeding and bladder perforation. There was a significant difference in the occurrence of ONR between the two groups (P = 0.0011). However, there was no significant difference between the two groups in the ability to resect the tumor and complete the surgery (P = .764). There was no correlation between the ONR and the tumor size (P = 0.478). Our study concluded that both ONB and IPIDP have comparable results, especially in resecting tumors and completing the operation. IPIDP has some advantages over ONB, such as shorter operative time, lower total costs, and less trained personnel requirements.