Non-muscle-invasive bladder cancer

Non-muscle-invasive bladder cancer

The aim of managing patients with NMIBC is to reduce the risk of tumour recurrence and progression to MIBC. Transurethral resection The initial management of bladder tumours consists of TURBT for accurate staging purposes. This is performed with a rigid cystoscope under general anaesthesia. A biman ual examination should be performed prior to resection to determine whether a mass is palpable and, if so, whether it is mobile or fixed. This should be repeated following resec tion. For lar ge tumours, a standard fractionated resection of the entire tumour, including the tumour base with deep muscle, is performed. For smaller (<3 /uni00A0 cm) solitary tumours, en bloc resection of the entire tumour can be performed and may reduce the risk of tumour recurrence by preventing the spread of tumour cells and subsequent implantation across the bladder. The following details should be recorded to enable accurate risk stratification: the size of the primary tumour, the number of tumours, the nodular or papillary features, concern for the presence of CIS and completeness of visual resection. - by - - - Mapping biopsies from the trigone, bladder dome and the right, left, anterior and posterior bladder wall should be taken if CIS is suspected.

Figure 83.35 Computed tomography showing a large right-sided bladder tumour. Figure 83.36 Cystoscopic appearance of a papillary bladder tumour.