A Different Obturator Nerve Block Approach Using Nerve Stimulation Device Under Fluoroscopy Guidance in the Transurethral Resection of Lateral Bladder Wall Tumors
Journal Title: The Medical Bulletin of Haseki - Year 2021, Vol 59, Issue 2
Abstract
Aim: This study aims to define the efficacy and safety of a different obturator nerve block technique using fluoroscopy and nerve stimulation device during transurethral resection of bladder tumor (TUR-BT). Methods: Sixty patients with lateral bladder wall tumors who had TURBT were retrospectively analyzed for the formation of obturator reflex. Thirty patients received spinal anesthesia (SA) and 30 patients received SA combined with an obturator nerve block (ONB). ONB was performed in the lithotomy position. A percutaneous needle was advanced to the superolateral portion of the obturator foramen under fluoroscopic guidance. The nerve was localized with a nerve stimulation device and 5 mL of 2% prilocaine was injected to perineural area. Additionally, the tumor base was marked intravesically by resectoscope with fluoroscopy and 5 mL of %2 prilocaine was administered to nearby tissue. Obturator reflex formation reflex-related related complications were compared between the two groups. Results: The results of our study yielded a statistically significant difference in the favor of ONB compared to SA alone for the occurrence of obturator reflex (13% vs 43%, p=0.020), bladder perforation (0% vs 23.3%, p=0.002), and absence muscle tissue in the pathological specimen (10% vs 40%, p=0.01). Conclusion: ONB with the help of a nerve stimulation device, directed by fluoroscopy is effective to prevent obturator reflex and related complications.
Authors and Affiliations
Cuneyd Sevinc, Tahir Karadeniz
Keywords
Related Articles
- EP ID EP693396
- DOI 10.4274/haseki.galenos.2021.6813
- Views 80
- Downloads 0
Imaging Findings of Cyst Hydatid Lesions in a Patient with Multiorgan Involvement: A Case of Hydatid Cyst with Multiorgan Involvement
Hydatid disease (HD) is a zoonosis caused by the larval form of the Echinococcus granulosus parasites in which human is the intermediate host. Hydatid cysts mainly develop in the liver and lungs. However, they can be fou...
Can We Use the RIPASA Scoring System in Cases of Suspicious Acute Appendicitis?
Aim: Acute appendicitis is the most common cause of acute abdomen. Although the Alvarado scoring system is one of the most commonly used tools in the diagnosis of acute appendicitis, the Raja Isteri Pengiran Anak Saleha...
Urological Complications and Management After Gynecological Operations
Aim: We aimed to evaluate the urological complications of gynecologic operations in a tertiary academic center and to evaluate the methods of treatment of these complications. Methods: Files of all patients, who underwe...
Effectiveness of Algan Hemostatic Agent in Bleeding Control: An Experimental Kidney Incision Model
Aim: The purpose of this study is to evaluate the hemostatic efficacy of a novel plant originated blood stopper which is called Algan Hemostatic Agent (AHA) in uncontrolled kidney incision bleeding model. Methods: The s...
Non-appendicitis Diagnoses in Patients Operated Due to Acute Appendicitis
Aim: The aim of the present study was to evaluate patients who were operated due to acute appendicitis and who were later determined to have non-appendicitis pathologies. Methods: The demographic characteristics, histop...