THE VALUE OF SECONDARY TRANSURETHRAL RESECTION FOR SUPERFICIAL BLADDER-TUMORS

With a recurrence rate of 60 to 70 % for superficial urothelial carcinoma of the bladder, complete transurethral resection is the basis of successful treatment. Single and differentiated resection, as well as secondary resection, are performed in these cases. We evaluated the impact of secondary resection (sec. TUR) by analysing 159 of our own cases. In an above-average occurrence of Tl tumors (48 %) revealed by primary resection, malignancy was found in 32 % by sec. TUR 4 to 6 weeks later. Carcinoma in situ (38 %), G3 (63 %) and multilocular (45 %) tumors, in particular, proved malignant in sec. TUR. The quality of primary resection was confirmed by the fact that secondary resection revealed only 1 out of 50 malignant tumors at the infiltrating T1 stage. In 9 cases, cis was only disclosed after sec. TUR. Comparable results found in the literature confirmed a malignancy rate of 18 to 63 % on secondary TUR. Arguments for performing routine secondary resection are: complete resection of the tumor to prevent ''early'' recurrence of residual tumors; improved conditions for commencement of chemoprophylaxis; and the detection of cis in order to precisely determine prognosis and plan adequate therapy.