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Avoiding the Obturator Jerk during TURBT

Avoiding the Obturator Jerk during TURBT Introduction: Bladder cancer is the seventh most common cancer in the UK. Transurethral resection of bladder tumor (TURBT) is a relatively common procedure used to treat cancer of the bladder. A serious complication of TURBT is bladder perforation, the risk of which is greatly increased in the presence of an “obturator jerk”. Methods: A literature search was performed on PubMed using the following search criteria “obturator nerve block”, “obturator nerve block in transurethral resection of bladder tumor”, “adductor spasm during transurethral resection of bladder tumor”, “bi-polar diathermy obturator nerve”, and “transvesical obturator nerve block”. Articles describing surgical and anesthetic techniques for reducing adductor spasm during resection of bladder tumors were included. Discussion: TURBT is a relatively common urological operation performed to remove tumors of the bladder. Every measure should be taken to avoid serious complications from both anesthesia and surgery. Surgical measures to reduce the likelihood of an obturator jerk include reducing the diathermy current, avoiding over-distention bladder, and using bipolar diathermy as opposed to monopolar diathermy (although there is conficting evidence for this in the literature). Anesthetists should consider the use of neuromuscular blockade or an obturator nerve block to reduce the incidence of obturator jerk and risk of bladder perforation. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Urology Karger

Avoiding the Obturator Jerk during TURBT

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References (23)

Publisher
Karger
Copyright
© 2018 The Author(s) Published by S. Karger AG, Basel
ISSN
1661-7649
eISSN
1661-7657
DOI
10.1159/000447223
Publisher site
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Abstract

Introduction: Bladder cancer is the seventh most common cancer in the UK. Transurethral resection of bladder tumor (TURBT) is a relatively common procedure used to treat cancer of the bladder. A serious complication of TURBT is bladder perforation, the risk of which is greatly increased in the presence of an “obturator jerk”. Methods: A literature search was performed on PubMed using the following search criteria “obturator nerve block”, “obturator nerve block in transurethral resection of bladder tumor”, “adductor spasm during transurethral resection of bladder tumor”, “bi-polar diathermy obturator nerve”, and “transvesical obturator nerve block”. Articles describing surgical and anesthetic techniques for reducing adductor spasm during resection of bladder tumors were included. Discussion: TURBT is a relatively common urological operation performed to remove tumors of the bladder. Every measure should be taken to avoid serious complications from both anesthesia and surgery. Surgical measures to reduce the likelihood of an obturator jerk include reducing the diathermy current, avoiding over-distention bladder, and using bipolar diathermy as opposed to monopolar diathermy (although there is conficting evidence for this in the literature). Anesthetists should consider the use of neuromuscular blockade or an obturator nerve block to reduce the incidence of obturator jerk and risk of bladder perforation.

Journal

Current Urology – Karger

Published: Jan 1, 2018

Keywords: Obturator jerk; Obturator reflex; Adductor spasm; Transurethral resection of bladder tumor

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