Objective: To investigate the effect of obturator nerve blockade on oncological outcomes of patients with a diagnosis of lateral wall localized non-muscle invasive bladder cancer. Materials and Methods: One hundred six patients diagnosed with lateral wall localized non-invasive bladder cancer were evaluated between January 2015 and March 2020 in this retrospective, cross-sectional observational study. The patients were divided into two groups: patients receiving only spinal anaesthesia and those receiving spinal anaesthesia combined with ultrasound-guided obturator nerve blockade. Oncological outcomes of the groups were compared statistically. Results: We observed recurrent tumours in 25 patients (45.5%) in Group 1 and 11 patients (21.6%) in Group 2. In addition, we observed tumour progression in eight patients (14.5%) in Group 1 and two patients (3.9%) in Group 2. We observed statistical significance in differences between groups regarding tumour size, recurrence rate, adequate muscle tissue sampling, the ability for complete resection and persistent obturator reflex. The efficacy rate of obturator blockade was 92.1% in Group 2. One-year recurrence-free survival (RFS) was 98.0% and five-year RFS was 23.5% for Group 1, while they were, respectively, 97.4% and 57.2% for Group 2. Conclusion: The obturator reflex is a common and challenging reflex that may cause major complications and result in unintended consequences such as incomplete resection or tumour recurrence with transurethral resection of bladder tumours. In this study, we demonstrated that combining spinal anaesthesia with obturator nerve blockade for lateral wall localized non-muscle invasive bladder cancer may prevent tumour recurrence and reduce perioperative complications.

Objective: To present a nation-wide analysis of the workload of urology departments in Turkey week-by-week during Covid-19 pandemic. Methodology: The centers participating in the study were divided into three groups as tertiary referral centers, state hospitals and private practice hospitals. The number of outpatients, inpatients, daily interventions and urological surgeries were recorded prospectively between 9-March-2020 and 31-May-2020. All these variables were recorded for the same time interval of 2019 as well. The weekly change of the workload of urology during pandemic period was evaluated; also the workload of urology and the distributions of certain urological surgeries were compared between the pandemic period and the same time interval of the year 2019. Results: A total of 51 centers participated in the study. The number of outpatients, inpatients, urological surgeries and daily interventions were found to be dramatically decreased by the third week of pandemics in state hospitals and tertiary referral centers; however the daily urological practice were similar in private practice hospitals throughout the pandemic period. When the workload of urology in pandemic period and the same time interval of the year 2019 were compared; a huge decrease was observed in all variables during pandemic period. However, temporary measures like ureteral stenting, nephrostomy placement and percutaneous cystostomy have been found to increase during Covid-19 pandemic compared to normal life. Conclusions: Covid-19 pandemic significantly effected the routine daily urological practice likewise other subspecialties and priority was given to emergent and non-deferrable surgeries by urologists in concordance with published clinical guidelines.