AB012. SOH25_AB_144. Quality of transurethral resection of bladder tumor (TURBT) in a level 4 hospital of Ireland

Background: This audit evaluates the quality of transurethral resection of bladder tumor (TURBT) procedures conducted at University Hospital Limerick, Ireland, over 12 months in 2023. TURBT is a critical procedure for diagnosing and managing bladder tumours, and adherence to established standards ensures optimal outcomes.

Methods: We performed a retrospective analysis on 49 TURBT cases to assess compliance with the European Association for Urology (EAU) and British Association of Urological Surgeons guidelines. Key parameters included post-operative mitomycin instillation, documentation of examination under anaesthesia (EUA), diagrammatic representation of findings, and histopathological sampling for muscle presence.

Results: In the first cycle, compliance rates were suboptimal, with 43.7% of indicated patients receiving mitomycin, 65.3% documentation of EUA findings, and 62.8% muscle presence in histopathology. The second cycle showed modest improvements: mitomycin compliance rose to 57.8%, EUA documentation to 70%, and muscle sampling to 63.3%. However, none of the improvements were statistically significant.

Conclusions: The audit highlights the need for structured interventions, including implementing surgical checklists, enhanced training on mitomycin instillation techniques, regular departmental briefings, and documentation audits. Continuous quality improvement initiatives are essential to ensure adherence to best practices in TURBT procedures. We recommend further review and targeted training to enhance compliance and patient outcomes.

Keywords: Bladder cancer; transurethral resection of bladder tumor (TURBT); mitomycin-C; European Association for Urology standards (EAU standards); documentation