Bladder Perforation During Trans-Urethral Resection of Bladder Tumors: Is the Open Exploration Ever Indicated?

Objectives: Management of bladder perforation during TURBT and to evaluate the need for open exploration? Materials and Methods: A retrospective study design was done and 1550 patients underwent TURBT for bladder mass from January 2005 to November 2023. 52 patients were identified with bladder perforation. 20 patients with T2 tumour on biopsy were excluded from final analysis. Parameters recorded on occurrence of a perforation included patient age and sex, tumor stage, grade, multiplicity, size, location, type of bladder perforation and management undertaken. Results: Of a total of 32 patients, 20 were male and 12 patients were female. The mean age of presentation was 65±12.34yrs. 19 patients had T1 tumors. The site of urinary bladder associated with the highest perforation was postero-lateral wall seen in 14 patients. None of the patients had past history of TURBT or were previously operated. A total of 10 patients (31.25%) had intra-peritoneal perforation and 22 patients (68.75%) had extra-peritoneal perforation. Conclusion: We conclude from our study that open exploration is seldom required for bladder perforation during TURBT unless there are signs of peritonism.