Editing Transurethral Resection of Bladder Tumour (section)

== Equipment ==

=== Lens ===
* Most commonly used lenses during rigid cystourethroscopy: 30° and 70°
*Urethra is best visualized using the 0 to 12° lens.
*'''<span style="color:#ff0000">For TURBT, a thorough visual inspection involves using (2):</span>''' 
*#'''<span style="color:#ff0000">30° lens to examine the urethra and then to perform a preliminary evaluation of the bladder mucosa and ureteral orifices.</span>''' 
*#'''<span style="color:#ff0000">70° lens should then be used to completely evaluate the bladder again with particular attention to the bladder neck, dome, and anterior wall.</span>'''
*#*The 70° or 120° lens are often required to inspect the anterior and inferolateral walls, dome, and neck of the bladder.
* '''<span style="color:#ff0000">For therapeutic purposes, a 30° lens is most often used</span>'''
** Resection is performed using a 12- or 30° lens because this deflection allows visualization of the cutting loop.

=== Monopolar vs. Bipolar ===

* '''Advantages of bipolar (compared to monopolar)'''
# '''Reduced risk of triggering an obturator reflex''' for tumours overlying the lateral walls of the bladder.
#'''Reduced risk of postoperative electrolyte abnormalities since bipolar uses 0.9% NS as irrigation'''
#*More relevant for TURP
# '''[Reduced bleeding, increased resection time]'''

=== Irrigation fluid ===

* '''<span style="color:#ff0000">Monopolar TURBT</span>'''
**'''<span style="color:#ff0000">Can be performed with 1.5% glycine or sterile water</span>'''
***'''<span style="color:#ff0000">Cannot be done with saline solutions</span>'''
****'''Saline conducts electricity and disperse energy from the monopolar cautery cutting loop'''
***1.5% glycine is more expensive than sterile water, and there is no evidence of its benefit in TURBT
*'''<span style="color:#ff0000">Bipolar TURBT</span>'''
**'''<span style="color:#ff0000">Performed with saline</span>'''