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Introduction and aim of the studySpinal anesthesia for transurethral resection of bladder tumor (TURB) does not prevent unintended stimulation of the obturator nerve when electroresection is performed on the lateral wall of the bladder. It results in muscle contraction of the adductor muscles of the thigh, which may lead to perforation of bladder wall with the resectoscope loop. The aim of the study was to assess the efficacy and safety of obturator nerve block (ONB).MethodsThis prospective study was conducted between 01/01/1999 and 12/31/2010 in the Department of General, Oncologic and Functional Urology, Medical University of Warsaw. In 431 patients undergoing TURB adductor spasms were observed. In these cases nerve stimulation and ONB with 2% lidocaine using thigh interadductor approach in the lithotomy position were performed.ResultsThe efficacy of 542 ONB was 94%. In 31 cases general anesthesia was necessary. There were two cases of urinary bladder perforation, but only one resulted from an insufficient nerve block. Both were managed conservatively. Neither hematomas nor neurological adverse events were observed.ConclusionThe described method offers a high rate of efficacy and ensures optimal and safe conditions for the resection of a tumor located on the inferolateral wall of the urinary bladder. The risk of complication is low.

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Solid organ transplant recipients are vulnerable to severe course of infectious diseases. Our study indicates that kidney transplant recipients are at high risk for severe COVID-19 illness and death, providing a rationale for prioritizing COVID-19 vaccination and aggressive management in this group. Kidney transplant recipients with lower baseline estimated glomerular filtration rate, a higher respiratory rate on admission and diabetes mellitus had increased risk of COVID-19 in-hospital mortality.