Transurethral resection of a bladder tumor (TURBT) contributes to morbidity of patients with bladder cancer. This trial evaluates the impact of an enhanced recovery after surgery (ERAS) protocol on quality of recovery from ambulatory TURBT.
In a prospective, single institution randomized controlled trial, patients undergoing ambulatory TURBT were randomized to ERAS (including pre-operative patient education, intraoperative and post-operative anesthesia/surgery interventions) or usual care, January 2024-May 2024. The primary endpoint was the mean difference in Quality of Recovery 15 (QoR-15) score (0-150, higher is superior recovery) between groups over day of surgery (DOS) and postoperative day 1 (POD1). Secondary endpoints included urinary tract infection-symptom impairment questionnaire (UTI-SIQ-8), pain scores, incontinence rates on POD1.
Patients were randomized in a 1:1 ratio to ERAS (n=50) or usual care (n=50). On multivariable analysis, mean QoR-15 was 12 points higher in ERAS group vs. controls for DOS and POD1, 137 versus 125, respectively (p<0.001). UTI-SIQ-8 was lower in the ERAS group vs. control: 5.8 vs. 12, p<0.001. ERAS patients experienced reduced urethral pain (2.4 vs. 4, p<0.01), penile/vulvar pain (1.3 vs. 2.7, p<0.01), dysuria (2.6 vs. 4.4, p<0.001), urinary incontinence (14% vs. 41%, p=0.02) vs. controls.
Utilization of ERAS for ambulatory TURBT significantly improves quality of recovery for patients with bladder cancer undergoing this common procedure.
The Journal of urology. 2026 Feb 09 [Epub ahead of print]
Michael E Rezaee, Michelle I Higgins, Zhuo Tony Su, Sadra Sepehri, Katherine Mahon, David Ali, Yuezhou Jing, Bruce J Trock, Nirmish Singla, Sunil H Patel, Max Kates
Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD.