Efficacy And Safety Of Transurethral Plasma Needle Electrode En Bloc Resection In The Treatment Of Cystitis Glandularis

Backgroud and object:Cystitis glandularis（CG）is an abnormal proliferative lesion of bladder mucosa in 1761,Morgagni et^[1]described the disease for the first time.In recent years,the incidence of cystitis glandularis has gradually increased.The etiology and pathogenesis of bladder cancer have not been fully elucidated,and the relationship between bladder cancer and bladder tumor is not clear,so the treatment plan is not unified.Some scholars believe that cystitis glandularis is a physiological phenomenon,which should be mainly conservative treatment,mainly eliminate pathogenic factors,regular follow-up:another view is that CG is a precancerous lesion,advocating surgical intervention combined with intravesical instillation therapy.The surgical methods include open surgery（bladder mucosal exfoliation,partial cystectomy or total cystectomy）and transurethral surgery（transurethral resection/cauterization,laser and plasma,etc.）,the latter has the advantage of minimally invasive surgery.It has become the main surgical treatment at present,but the long-term effect is not good.With the continuous innovation and development of surgical settings,it is possible to explore new treatment methods in clinic.In this paper,a new surgical method:transurethral plasma needle electrode block resection for cystitis glandularis was proposed,and its safety and efficacy were analyzed.Methods:From July 2017 to December 2018,32 patients with CG were treated in Department of Urology,General Hospital of Tianjin Medical University.transurethral plasma needle electrode resection and transurethral plasma resection were performed respectively.The perioperative clinical data and follow-up results of the two groups were collected and statistically analyzed to analyze the efficacy and safety of the new operation.Results:The operation was completed successfully in both groups,and no serious complications such as bladder perforation occurred.The difference of blood loss and perioperative hemoglobin in the needle electrode group was lower than that in the control group,and there was statistical significance.There was no significant difference in operation time,bladder irrigation time,catheter time,obturator nerve reflex and postoperative bladder irritation between the two groups.The improvement rate of the experimental group（92.9%）was significantly higher than that of the control group（77.8%）,but there was no significant difference between the experimental group and the control group.No serious chemotherapy-related adverse reactions occurred during perfusion chemotherapy in both groups.Conclusion:This study shows that transurethral needle electrode resection is a safe and effective surgical method,and has the potential to replace the traditional electroresection.Needle electrode has a unique advantage in patients with CG involving ureteral orifice and is a new method for the treatment of CG.