Quality Assessment Of Turbt For Non-Muscle Invasive Bladder Cancer: A Single-Center Audit

A Clinical Audit

Abstract

Background: Transurethral resection of bladder tumors (TURBT) is a cornerstone in managing non-muscle-invasive bladder cancer (NMIBC). Accurate documentation and adherence to clinical guidelines are essential to optimize outcomes and reduce recurrence rates. This audit evaluates the quality of TURBT procedures at the Department of Urology, Pakistan Kidney and Liver Institute and Research Center (PKLI & RC), Lahore.

Methods:This retrospective audit included data from 41 NMIBC patients who underwent TURBT between January and September 2024. Data collection focused on patient demographics, imaging findings, procedural and intraoperative details, and pathological reports. Statistical analysis was conducted to describe sample characteristics and evaluate documentation completeness and guideline adherence.

Results: Mitomycin-C was administered within the recommended 24-hour postoperative window in only 29% of patients (n=12). Documentation gaps were noted, with tumor appearance recorded in 58% of cases and mitomycin-C use documented in 63%. Detrusor muscle presence was confirmed in 90% of pathology reports (n=37). However, multidisciplinary team (MDT) discussions were conducted for only 20% of high-risk cases.

Conclusion:This audit highlights critical gaps in TURBT quality, such as suboptimal mitomycin-C administration and limited MDT reviews. Implementing standardized documentation protocols, ensuring timely postoperative care, and regular re-audit cycles are recommended to enhance care quality and outcomes for NMIBC patients. Addressing these gaps would likely significantly reduce recurrence rates and improve long-term prognosis.

Keywords: Transurethral Resection of Bladder Tumor (TURBT); Non-Muscle Invasive Bladder Cancer (NMIBC); Quality Assessment; Bladder Cancer; Audit; Mitomycin-C