Abstract
<title>Abstract</title> <p>Transurethral resection of bladder tumor (TURBT) may disrupt the urothelial glycosaminoglycan layer and contribute to postoperative overactive bladder-like symptoms. This open-label, single-center randomized controlled trial evaluated whether early intravesical instillation of a regenerative biomaterial improves postoperative urinary symptom recovery after TURBT. Patients undergoing TURBT were randomized 1:1 to receive standard TURBT followed by three early intravesical Blad-Care™ instillations or standard TURBT alone. The co-primary endpoints were between-group differences in Overactive Bladder Symptom Score (OABSS) and pain numeric rating scale score at 2 weeks. Among 57 patients assessed for eligibility, 52 were randomized and analyzed. The co-primary endpoints were not met. At 2 weeks, OABSS did not differ significantly between the control and regenerative biomaterial groups (7.5 ± 4.9 vs. 5.2 ± 3.4; P = 0.110), and pain remained minimal in both groups. During later follow-up, the regenerative biomaterial group showed lower OABSS at 3 months (4.1 ± 2.7 vs. 7.3 ± 4.3; P = 0.007) and 6 months (3.9 ± 3.2 vs. 7.8 ± 4.3; P = 0.037). These exploratory findings suggest a possible delayed effect on urinary symptom recovery, warranting confirmation in larger blinded trials. Trial registration: Clinical Research Information Service, KCT0009775; registered September 10, 2024.</p>