Second transurethral resection of superficial transitional cell carcinoma of the bladder: A must even for experienced urologists

Introduction: As even experienced urologists have a high percentage of persisting carcinoma after transurethral bladder tumour resection (TUR-B) the importance of a routine second resection in the management of transitional cell carcinoma (TCC) of the bladder is defined. Patients and Methods: The medical records of all patients treated with TUR-B at our institution between January 1989 and September 2000 were reviewed. 214 patients with pTa and pT1 carcinoma undergoing a second resection 4-6 weeks later were included in the analysis. The rate of persisting carcinoma in the second resection was compared to the actual tumour stage and grade, the patient's age, sex and the experience of the urologist performing the resection. Results: Of the 214 patients 99 had pTa and 115 pT1 carcinoma. The rate of persisting tumour in the second resection was 27% in pTa and 37% in pT1 carcinoma. This rate was independent of the patient's age and sex. Urologists in training had an equally low rate of persisting carcinoma in the second resection compared to senior urologists (p = 0.08). Conclusions: Routine second resection of superficial transitional cell carcinoma of the bladder should be part of the treatment even in larger operative experience. Copyright (C) 2004 S. Karger AG, Basel.