Female gender and low body mass index (BMI) are risk factors for inadvertent bladder performation during transurethral resection of bladder tumors, German researchers reported online ahead of print in the Journal of Urology.

Kathleen Herkommer, MD, and collaborators at the Technische Universität München, Klinikum rechts der Isar, Munich, reviewed records of 1,284 patients with bladder cancer who underwent transurethral resection of bladder tumors. A total of 49 bladder perforations (3.8%) occurred. Of these, 89.8% were extraperitoneal and 10.2% were intraperitoneal.

Bladder perforation occurred significantly more frequently in female than male patients (7.2% vs. 2.6%) and in those with a BMI less than 25 kg/m2 than in patients with a BMI of 25-30 and greater than 30 (5.5% vs. 3.4% and 0.6%, respectively).

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In addition, the study showed that the rate of bladder perforation was significantly higher when tumor resection weight was 20 grams or higher compared with a weight of 2.5 grams or less (9.2% vs. 2.4%).

The authors noted that bladder perforation is the second most common complication of transurethral resection of bladder tumors.