CODE: 8.2 - The role of the second transurethral resection of the bladder tumors in managing and evaluating the patients with superficial bladder tumors
Article published in Urologia Polska 2006/59/Suplement 1.

authors

Janusz Ciechan, Ireneusz Ostrowski, Krzysztof Mazurek

Oddział Urologii Szpitala Specjalistycznego w Puławach

summary

Introduction. The aim of transurethral resection of the bladder tumors (TURT) is to remove all the tumors and to assess the local extent of the disease.

Purpose. The role of routine second transurethral resection (re-TURT) in evaluating and managing the bladder tumors is defined. We evaluated the number of visible residual tumors, their staging (T) and grading (G).

Materials and methods. From May 2004 to December 2005, 30 patients (24 males and 6 females) with new superficial bladder tumors underwent repeat standard transurethral resection of the scar from initial resection and other suspicious lesions within 4 weeks after the initial resection. In this group there were 16 (53%) patients with a single tumor (4 with Ta, 5 Ta/T1, 7 T1) and 14 (47%) with multiple tumors (2 with Ta, 6 Ta/T1, 6 T1). In the opinion of an experienced urologist the first TURT was complete.

Results. Of the 30 patients who underwent re-TURT 20 (67%) had no and 10 (33%) had residual tumors, including 1 (3%) of Ta, 2 (6%) of Ta/T1 and 7 (24%) of T1 disease. Among them 5 (17%) had a primary single tumor, 5 multiple primary tumors. 6 (20%) had residual tumors at the initial resection site, 4 (13%) had additional focus. Furthermore, after histopathological assessment of re-TURT specimens, 3 tumors were downgraded and one upstaged to T2.

Conclusions. Many patients with bladder tumors have tumor present after an initial transurethral resection. In our material residual cancers were found in 33%. Routine re-TURT is effective and helpful in detecting residual cancer and allows verification of the first pathological assessment.