The value of a second transurethral resection in evaluating patients with bladder tumors

Purpose: The role of a routine second transurethral resection in evaluating and managing bladder tumors is defined. Materials and Methods: From January to October 1998, 150 patients with new or recurrent bladder tumors underwent repeat transurethral resection within 2 to 6 weeks after the initial resection, and the results, including the presence of residual tumor and tumor stage, were compared. Results: Of the 150 cases 36 (24%) had no and 114 (76%) had residual tumor on repeat transurethral resection. Of 96 cases with superficial (Ta, Tis, T1) bladder tumors 72 (75%) had residual. noninvasive tumor and 28 (29%) were up staged to invasive tumor. Among 54 patients with a muscle invasive tumor 12 (22%) had no residual tumor on repeat transurethral resection. Results of the second resection changed tumor treatment in 50 patients (33%). Conclusions: Many patients with bladder tumors have tumor present after an initial transurethral resection. Routine repeat resection is advised to control noninvasive tumors and to detect residual tumor invasion.