Research Article

Ultrasound-guided obturator nerve block in transurethral resection of bladder tumors: a single-center retrospective observational study

Volume: 9 Number: 3 May 19, 2026
Journal of Health Sciences and Medicine Cover
Journal of Health Sciences and Medicine
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Ultrasound-guided obturator nerve block in transurethral resection of bladder tumors: a single-center retrospective observational study

Abstract

Aims: Obturator reflex during transurethral resection of bladder tumors (TUR-M), particularly in lateral wall lesions, may cause serious intraoperative complications. This study aimed to evaluate the clinical effectiveness and safety of ultrasound-guided obturator nerve block (ONB) in preventing obturator reflex during TUR-M. Methods: This single-center retrospective observational study included adult patients who underwent TUR-M with ultrasound-guided ONB between January 2022 and September 2025. Demographic data, anesthetic techniques, ONB characteristics, intraoperative obturator reflex occurrence, and block-related complications were obtained from anesthesia and surgical records. ONB was performed using a standardized ultrasound-guided distal two-branch technique with additional nerve stimulation for functional confirmation. Block success was defined as the absence of clinically significant obturator reflex during surgery. Results: A total of 989 TUR-M procedures were performed during the study period, and ultrasound-guided ONB was applied in 143 patients. After exclusion of patients with incomplete or inconsistent data, 137 patients were included in the analysis. Obturator reflex occurred in 9 patients (6.5%), resulting in an overall block success rate of 93.4%. All surgical procedures were completed successfully despite reflex occurrence. No block-related or local anesthetic-related complications were observed. Obturator reflex was observed only in patients who received unilateral ONB, while no reflex occurred in bilateral applications. There was no statistically significant difference in block success between unilateral and bilateral ONB (p=0.61). Conclusion: Ultrasound-guided ONB, performed using a standardized distal two-branch technique with nerve stimulation confirmation, is a safe and highly effective adjunctive method for preventing obturator reflex during TUR-M. This approach may enhance surgical safety and operative comfort, particularly in patients with laterally located bladder tumors.

Keywords

Supporting Institution

none

Ethical Statement

This study was conducted in accordance with the principles of the Declaration of Helsinki and was approved by the Samsun University Non-Interventional Clinical Research Ethics Committee (Decision No: 2025/21/36, Date: November 5, 2025). Due to the retrospective design of the study, the requirement for informed consent was waived.

References

  1. Alavi CE, Asgari SA, Falahatkar S, et al. Effectiveness of spinal anesthesia combined with obturator nerve blockade in preventing adductor muscle contraction during transurethral resection of bladder tumor. Turk J Urol. 2017;43(4):507-511. doi:10.5152/tud.2017.12345
  2. Krishan A, Bruce A, Khashaba S, Abouelela M, Ehsanullah SA. Safety and efficacy of transurethral resection of bladder tumor comparing spinal anesthesia with spinal anesthesia plus obturator nerve block: a systematic review and meta-analysis. J Endourol. 2021;35(3):249-258. doi:10.1089/end.2020.1234
  3. Akata T, Murakami J, Yoshinaga A, et al. Life-threatening obturator nerve reflex during transurethral resection of bladder tumor. Anesthesiology. 1999;90(3):1005-1006.
  4. Tatlişen A, Sofikerim M. Obturator nerve block and transurethral surgery for bladder cancer. Minerva Urol Nefrol. 2007;59(2):137-141.
  5. Han C, Ma T, Lei D, Xie S, Ge Z. Effect of ultrasound-guided proximal and distal approaches for obturator nerve block in transurethral resection of bladder cancer under spinal anesthesia. Cancer Manag Res. 2019;11:2499-2505. doi:10.2147/CMAR.S195213
  6. Topçu H, Aydın C, Şentürk AB, Yağan Ö. Effect of ultrasound-guided obturator nerve block on complications in transurethral resection for bladder cancer. J Urol Surg. 2023;10(1):25-30. doi:10.4274/jus.galenos. 2022.2022-6-3
  7. Öksüz G, Arslan M. Effectiveness of ultrasound-guided obturator nerve block in transurethral resection of bladder tumors. Akdeniz Med J. 2019; 5(2):349-352.
  8. Aksu C, Gürkan Y, Kuş A, Toker K, Solak M. Ultrasound-guided obturator nerve block: one-year experience at Kocaeli University Hospital. Agri. 2016;28(1):39-41.

Details

Primary Language

English

Subjects

Anaesthesiology, Urology

Journal Section

Research Article

Authors

Publication Date

May 19, 2026

Submission Date

January 7, 2026

Acceptance Date

March 28, 2026

Published in Issue

Year 2026 Volume: 9 Number: 3

IZ

https://izlik.org/JA79WR39YN

Cite

RIS / Bibtex
APA
Ertaş, G., Şenol Çakmak, H., Demirci, A. C., Ordulu, R., Tulgar, S., & Süren, M. (2026). Ultrasound-guided obturator nerve block in transurethral resection of bladder tumors: a single-center retrospective observational study. Journal of Health Sciences and Medicine, 9(3), 591-595. https://izlik.org/JA79WR39YN
AMA
1.Ertaş G, Şenol Çakmak H, Demirci AC, Ordulu R, Tulgar S, Süren M. Ultrasound-guided obturator nerve block in transurethral resection of bladder tumors: a single-center retrospective observational study. J Health Sci Med / JHSM. 2026;9(3):591-595. https://izlik.org/JA79WR39YN
Chicago
Ertaş, Gamze, Hamiyet Şenol Çakmak, Alparslan Can Demirci, Reha Ordulu, Serkan Tulgar, and Mustafa Süren. 2026. “Ultrasound-Guided Obturator Nerve Block in Transurethral Resection of Bladder Tumors: A Single-Center Retrospective Observational Study”. Journal of Health Sciences and Medicine 9 (3): 591-95. https://izlik.org/JA79WR39YN.
EndNote
Ertaş G, Şenol Çakmak H, Demirci AC, Ordulu R, Tulgar S, Süren M (May 1, 2026) Ultrasound-guided obturator nerve block in transurethral resection of bladder tumors: a single-center retrospective observational study. Journal of Health Sciences and Medicine 9 3 591–595.
IEEE
[1]G. Ertaş, H. Şenol Çakmak, A. C. Demirci, R. Ordulu, S. Tulgar, and M. Süren, “Ultrasound-guided obturator nerve block in transurethral resection of bladder tumors: a single-center retrospective observational study”, J Health Sci Med / JHSM, vol. 9, no. 3, pp. 591–595, May 2026, [Online]. Available: https://izlik.org/JA79WR39YN
ISNAD
Ertaş, Gamze - Şenol Çakmak, Hamiyet - Demirci, Alparslan Can - Ordulu, Reha - Tulgar, Serkan - Süren, Mustafa. “Ultrasound-Guided Obturator Nerve Block in Transurethral Resection of Bladder Tumors: A Single-Center Retrospective Observational Study”. Journal of Health Sciences and Medicine 9/3 (May 1, 2026): 591-595. https://izlik.org/JA79WR39YN.
JAMA
1.Ertaş G, Şenol Çakmak H, Demirci AC, Ordulu R, Tulgar S, Süren M. Ultrasound-guided obturator nerve block in transurethral resection of bladder tumors: a single-center retrospective observational study. J Health Sci Med / JHSM. 2026;9:591–595.
MLA
Ertaş, Gamze, et al. “Ultrasound-Guided Obturator Nerve Block in Transurethral Resection of Bladder Tumors: A Single-Center Retrospective Observational Study”. Journal of Health Sciences and Medicine, vol. 9, no. 3, May 2026, pp. 591-5, https://izlik.org/JA79WR39YN.
Vancouver
1.Gamze Ertaş, Hamiyet Şenol Çakmak, Alparslan Can Demirci, Reha Ordulu, Serkan Tulgar, Mustafa Süren. Ultrasound-guided obturator nerve block in transurethral resection of bladder tumors: a single-center retrospective observational study. J Health Sci Med / JHSM [Internet]. 2026 May 1;9(3):591-5. Available from: https://izlik.org/JA79WR39YN

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