PTU - Polskie Towarzystwo Urologiczne
list of articles:

Own method of obturator nerve blockade during transurethral resection of tumor localized on lateral bladder walls
Article published in Urologia Polska 2006/59/3.


Andrzej J. Wrona 1, Krzysztof Bar 2, Piotr Cwenar 2, Radosław Starownik 2
1 Oddział Urologii Szpital Powiatowy w Mielcu
2 Katedra i Klinika Urologii i Onkologii Urologicznej Akademii Medycznej w Lublinie


urinary bladder, transurethral resection, blockade of obturator nerve


Introduction and the aim of the study. The transurethral resection (TURT) is the basic treatment of the superficial tumours of urinary bladder. In case of lesion placed in neighbourhood of ureteral orifices in tract of resection comes to irritation of obturator nerve, which manifests in the contraction of thigh muscle adductors. The aim of study was the estimation of obturator nerve blockade effectiveness with help of local anaesthesia done with use of own construction set.
Material and method. 115 patients (average age 64 years) with tumor situated on lateral walls of urinary bladder were classified to obturator nerve anesthesia, when subarachnoid anesthesia was carried out earlier. In case of thigh muscles adductors reaction local anaesthesia was done additionally in neighbourhood of tumor basis by 2% Lidocain with the use of a needle made by one's own idea.
Results. In 12 cases after having stated discontent degree of obturator nerve blockade a decision to give anaesthetic was made what allowed to continue endoscopic operation. In this group complications associated with conducted procedure were not observed.
Conclusions. The blockade of obturator nerve with the help of local anaesthesia is a safe method, preventing the uncontrolled spasms of thigh muscle adductors, which protects from the perforation of bladder wall.


  1. Beisland HO, Sander S: Neodymium - YAG laser irradiation of stage T2 muscle - invasive bladder cancer. Long-term results. Br J Urol 1990, 65, 24-26.
  2. Flamm J, Steiner R: Stellenwert der differenzierten transurethralen Resektion beim primären oberflächlichen Harnblasen karzinom. Urologia 1990, 30, 111-113.
  3. Klän R, Loy V, Huland H: Residual tumor discovered in routine second transurethral resection in patients with stage T1 transitional cell carcinoma of the bladder. J Urol 1991, 146, 316-318.
  4. Herr HW: The value of a second transurethral resection in evaluating patients with bladder tumors. J Urol 1999, 162, 74-77.
  5. Kolozsy Z: Histopathological ,,self control\" in transurethral resection of bladder tumours. Br J Urol 1991, 67, 162-164.
  6. Makiełło J, Szkodny A: Przyczynek do diagnostyki i terapii endoskopowej guzów pęcherza moczowego. Dwupoziomowe znieczulenie przewodowe, dodatkowa blokada nerwu zasłonowego. Urol Pol 1981, 34, 3-4.
  7. Makiełło J, Prajsner A: Lokalizacja i blokada nerwu zasłonowego przy użyciu stymulatora Tracer NL-1. Urol Pol 1991, 44, 102-104.
  8. Ciechomski M: Blokada nerwu zasłonowego podczas przezcewkowego wycięcia guza pęcherza moczowego. Urol Pol 2004, 57, 58- 61.


Krzysztof Bar
Klinika Urologii AM
ul. Jaczewskiego 8
20-954 Lublin
tel. (081) 742 55 72... 3