***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose To establish whether bipolar transurethral resection of tumours ( bTURB ) on the lateral bladder wall is superior to monopolar transurethral resection ( mTURB ) of such tumours . To our knowledge , this is the first prospect i ve r and omised study , which defines complete resection depending on obturator jerk as primary endpoint . Methods In a prospect i ve , r and omised , single centre study , 52 patients with newly diagnosed or recurrent bladder tumour on the lateral bladder wall were enrolled and r and omised to undergo mTURB or bTURB ; 44 patients were eligible for analysis , of whom 21 underwent mTURB and 23 bTURB .  Any differences between the two techniques related to the incidence of unwanted stimulation of the obturator nerve and subsequent adductor spasms were evaluated . All procedures were carried out under laryngeal mask anaesthesia without obturator nerve block ( ONB ) and without drug-induced relaxation . Results Baseline characteristics of the two study groups did not differ statistically significantly . The success rate defined as complete resection of the bladder tumour without any clinical ly relevant adductor spasm was 61.9 % in the monopolar group and 82.6 % in the bipolar group ( p = 0.18 ) . Conclusions Complete , undisturbed resection of tumours of the lateral bladder wall is feasible with mTURB and bTURB . Adductor spasms due to obturator jerk can occur suddenly with the risk of bladder perforation . We therefore support ONB when using spinal anaesthesia and drug-induced relaxation when using general anaesthesia when performing TURB on the lateral bladder wall ABSTRACT Introduction : To compare the perioperative outcomes and complications of monopolar and bipolar transurethral resection of bladder tumors ( TURBT )  in patients with coronary artery disease ( CAD ) . Material s and Methods : A total of 90 CAD patients with newly diagnosed bladder cancer who underwent TURBT  were r and omized into monopolar TURBT ( M-TURBT ) and bipolar TURBT ( B-TURBT ) groups . Primary outcome was safety of the procedures including obturator jerk , bladder perforation , clot retention , febrile urinary tract infection and TUR syndrome . The secondary outcome was the efficacy of TURBT procedures , including complete tumor resection , sampling of the deep muscle tissue and sampling of the qualified tissues without any thermal damage . Results : Mean ages of the patients in M-TURBT and B-TURBT groups were 71.36±7.49 and 73.71±8.15 years , respectively ( p=0.157 ) . No significant differences were found between M-TURBT and B-TURBT groups regarding complete tumor resection ( 76.2 % vs. 87.5 % , p=0.162 ) and muscle tissue sampling rates ( 71.4 % vs. 64.6%,p=0.252 ) . Obturator jerk was detected in 16.7 % of the patients in M-TURBT group and 2.1 % in B-TURBT group ( p=0.007 ) . No statistically significant differences were found between the groups regarding intraoperative and postoperative complications . Conclusions : Both monopolar and bipolar systems can be used safely and effectively during TURBT procedure in CAD patients . Due to the more frequently seen obturator jerk in M-TURBT than B-TURBT , careful surgical approach is needed during M-TURBT Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Abstract Objective : To compare the safety and efficacy of bipolar vs monopolar transurethral resection of bladder tumour ( TURBT ) in patients maintained on low-dose aspirin with tumours > 3 cm . Patients and methods : A prospect i ve r and omised single-centre study was performed including 200 patients with bladder tumours of > 3 cm , as measured by ultrasonography . All patients were using low-dose aspirin ( 81 mg/day ) , which was not stopped in the perioperative period . Patients were r and omised into two groups : Group A , monopolar TURBT ( M-TURBT ) ; Group B , bipolar TURBT ( B-TURBT ) . The primary endpoint of the study was the decrease in postoperative haemoglobin ( Hb ) concentration measured using an automated cell counter . The secondary endpoints of the study were intraoperative blood transfusion or the occurrence of urethral trauma during cystoscopy and the need for re-coagulation . Results : The postoperative reduction in Hb concentration , was significantly lower in the B-TURBT group [ mean ( SD ) 0.55 ( 0.26 ) g/dL ] compared with the M-TURBT group [ mean ( SD ) 1.24 ( 0.61 ) g/dL ] ( P < 0.001 ) . There was also a significant difference ( in favour of B-TURBT ) between the groups in the mean postoperative reduction in haematocrit and the mean postoperative hospital stay . There was no significant difference between the groups for the occurrence of obturator jerk , bladder perforation , and the need for blood transfusion . Conclusion : B-TURBT in patients maintained on low-dose aspirin is better than M-TURBT for minimising postoperative drop in Hb concentration PURPOSE We compared the safety and efficacy of bipolar transurethral resection and monopolar resection for bladder tumors . MATERIAL S AND METHODS A single center , parallel arm , r and omized , controlled trial was performed from May 2011 to August 2012 . All patients with suspected bladder tumors were eligible for study inclusion . Those who refused consent and those undergoing routine restaging transurethral resection of bladder tumor were excluded from analysis . The primary end point was the incidence of obturator jerk . Secondary study outcomes included the decrease in hematocrit , rates of recoagulation and transfusion , bladder perforation , decrease in sodium , resection syndrome and resection time . Pathological quality was assessed by comparing deep muscle and the degree of severe cautery artifact in the 2 arms . RESULTS A total of 257 transurethral resections  were performed during the study period . After exclusion 147 patients were r and omized , including 75 in the monopolar arm and 72 in the bipolar arm . There were 6 and 4 protocol violations in the monopolar and bipolar arms , respectively . Intent to treat and per protocol analyses were performed . The incidence of obturator jerk was greater in the bipolar arm ( 60 % vs 49.2 % , p=0.27 ) . There was no significant difference between secondary outcomes . The only significant difference was a significantly lower incidence of severe cautery artifact in the bipolar arm ( 25 % vs 46.7 % , p=0.0096 ) . CONCLUSIONS Bipolar transurethral resection of bladder tumor was not superior to monopolar resection with respect to obturator jerk , bladder perforation and hemostasis . There was a significantly lower incidence of severe cautery artifact after bipolar resection OBJECTIVES To compare the safety and the efficacy of plasmakinetic bipolar resectoscope versus conventional monopolar in the transurethral resection of primary non-muscle invasive bladder cancer . METHODS From January 2007 to December 2009 , 132 patients underwent endoscopic resection for primary non-muscle invasive bladder cancer . They were r and omly assigned to two groups : 67 patients underwent a transurethral resection of the bladder with bipolar plasmakinetic energy transurethral resection of the bladder  and 65 were treated with conventional monopolar transurethral resection .  RESULTS The mean operative time was 27 min for bipolar plasmakinetic energy transurethral resection of the bladder and 31 min for monopolar transurethral resection of the bladder . No significant differences in the mean change of hemoglobin and serum sodium level were observed . Mean catheterization time was 1.3 days and 2.3 days for bipolar plasmakinetic energy transurethral resection of the bladder and monopolar transurethral resection of the bladder , respectively . The mean hospital stay was shorter in the bipolar plasmakinetic energy transurethral resection of the bladder . Bladder perforation was reported in two cases for the monopolar transurethral resection of the bladder group and obturator nerve reflex occurred in a single case for both procedures . None of the patients experienced transurethral resection syndrome . The median time of bladder tumor recurrence after initial transurethral resection of the bladder was 12.4 months and 11.9 months for bipolar plasmakinetic energy transurethral resection of the bladder and monopolar transurethral resection of the bladder , respectively . No significant differences in the overall recurrence-free survival rate were observed comparing the two procedures . CONCLUSIONS Plasmakinetic bipolar transurethral resection represents a safe and effective procedure in the management of non-muscle invasive bladder cancer BACKGROUND AND PURPOSE Bipolar transurethral resection  of bladder tumors ( TURBTs ) has been cl aim ed to have lesser complications and better specimen quality , but recent studies have contradictory results , and hence , we conducted this study to compare the clinical efficacy and safety of monopolar and bipolar electrosurgical modalities in TURBTs . MATERIAL S AND METHODS A total of 287 patients were enrolled in the study and underwent TURBTs between July 2015 and September 2016 . Patients undergoing surgery under general anesthesia and restage procedure were excluded from the study .  Patient demographic profile , tumor characteristics , and complications of the procedures such as obturator jerk , bladder perforation , blood loss , need for resurgery , and transurethral resection syndrome were recorded . Tumor specimens were analyzed for stage , grade , deep muscle invasion , and quantity and quality of thermal artifacts . RESULTS A total of 160 patients were block r and omized and analyzed with 80 patients in either group . Patient demographics and tumor characteristics were comparable between the groups . Change in hemoglobin levels and incidence of bladder perforation were comparable between the groups . A higher proportion of patients in bipolar group had obturator jerk compared with those in monopolar group , however , it was not statistically significant ( 24 % vs 14 % ; p = 0.23 ) . A higher proportion of patients in bipolar group did not have thermal artifacts when compared with monopolar group ( 27.5 % vs 5 % ; p < 0.0001 ) . CONCLUSIONS The operative risks of bipolar TURBT such as obturator jerk , bladder perforation , and blood loss are comparable with monopolar resection . However , less thermal artifacts in tissue sample s obtained with bipolar resection may be helpful to the pathologist in interpretation of histopathologic findings 
    Output:
    
Bipolar and monopolar devices are equally safe in terms of obturator jerk and bladder perforation .