Obturator Nerver To Get Fatigued For Prevent Of Obturater Nerve Reflex In TURBt (with 98 Case)

Background and purposeThe most widespread surgical treatment for superficial bladder tumor is transurethral resection. Although the clinical efficacy of this procedure is well know, spontaneous thing adductor contraction cause by the electrically stimulate obturator nerve may lead to bladder perforation. To prevent such a reaction an obturator nerve block is needed, especially for resecting tumor on the lateral bladder wall. we developed a new way to prevent obturator nerve block is obturator nerve to get fatigued.Materials and MethodsFrom September 2000 to may 2007, the patients who were suffered from the blood urine without pain were diagnosed as bladder tumor by routine testing, urinary cytology and flowcytometry, cystoscopy and biopsy, imaging (CT and MRI). The 98 cases is transurethral resected by obturator nerve to get fatigued. The result compared with local obturator nerve block.All the patient were accepted the TURBt in the peridural anesthesia or combined spinal-eqidural anesthesia. Electric resection power is 180W and electric coagulation power is 80W. Frist electric coagulation near tumor about 1.5cm by electrode, if it is spasm incessant coagulate unless it is stop, follow Electric resection incessant stimulate unless it is disappearance, than TURBt by routine.ResultAll of 98 cases had operated successfully. The mean time of operation was 24min (10-60min). The standard of obturater nerve reflex's strength is light swing of hind limb, mild swing of hind limb, fierce swing of hind limb. It has 82 obturater nerve reflex by Pre- coagulation, the number of reflex is 1-108 (light: 10 cases, mild : 55 cases, fierce: 17 cases). It has 22 obturater nerve reflex by Pre-resection, the number of reflex is 1-5 (light: 11 cases, mild : 11 cases). It has 32 obturater nerve reflex by rule resection, the number of reflexis 1-5 (light:25 cases, mild :7 cases), no bladder perforation and it has alike effect with local obturator nerve block 98.9%(97/98)ConclusionObturator nerve to get fatigued for prevent of obturater nerve reflex in TURBt is a new way. It has more forte such as high efficiency, save time and needless especially equipment.