[Diagnosis and treatment of superficial bladder cancers]

By definition, superficial bladder tumours do not invade the bladder muscle. The two main risk factors are smoking and industrial carcinogens. Gross hematuria is the most common presenting sign of bladder tumour; its finding should always prompt a cystoscopy of the lower urinary tract. The finding of a bladder tumour always requires assessment of the upper urinary tract. Endoscopic resection, performed under locoregional or general anaesthesia, is the first step in treating superficial bladder tumours. It should be complete and as deep as possible (muscle). Additional treatment with intravesical instillations may be necessary according to the at-risk group defined by the Cancer Committee of the French Urological Association. Intravesical instillations essentially consist of intravesical chemotherapy (mitomycin C) and intravesical immunotherapy (BCG). They aim at reducing the risk of tumour recurrence, as well as the risk of progression to bladder muscle invasion.