How to improve the effectiveness of transurethral resection in nonmuscle invasive bladder cancer?
Evelyne C C Cauberg1, Jean J M C H de la Rosette, Theo M de Reijke
1Department of Urology, Academic Medical Center Amsterdam, The Netherlands. e.c.cauberg@amc.uva.nl
Purpose Of Review:
The high rate of early recurrences in nonmuscle invasive bladder cancer is considered to be strongly related to the effectiveness of transurethral resection (TUR). The aim of this article is to review methods, currently available or in development, that aim at improving TUR, with an emphasis on studies over the past year.
Recent Findings:
It has been shown that re-TUR diminishes staging error and improves local tumour control. However, instead of simply repeating the standard procedure, it makes more sense to improve the technique itself. Modifications in TUR equipment, such as bipolar resection and laser treatment, mainly have the potential to reduce complication rates and possibly thereby improve the effectiveness of TUR. New imaging techniques that can be used during TUR such as narrow-band imaging and optical coherence tomography seem promising, whereas photodynamic diagnosis has already proven its potential role in improving the effectiveness of TUR.
Summary:
The currently available techniques of re-TUR and photodynamic diagnosis have demonstrated potential to improve effectiveness of TUR and should be used in selected cases. New techniques such as narrow-band imaging and optical coherence tomography seem promising, but more evidence is needed before these methods can be implemented in daily practice.
