[Diagnosis of urinary bladder cancer by transurethral sonography]

With 66.5% the total reliability of the transurethral sonography is significantly higher than that of all methods hitherto used. If one restricts oneself to the differentiation between muscle-invasive and superficial carcinomas the share of impacts is even 77.5%. Considering an error of nevertheless 33% and 23%, respectively, in the T-classification of the carcinoma of the urinary bladder the new method could, however, not fulfil the high expectations which were set into it at the beginning. Particularly a differentiation between mucosa and lamina propria as well as superficial and deep musculature is not possible. According to this the transurethral sonography is not suited as the only method for preoperative T-classification and basis of therapy planning. Difficulties appear above all in large and echo-dense carcinomas, respectively, as well as in pretreated urinary bladders. Consequently, a sufficient experience in the judgment of sonogrammes is necessary, in order to avoid wrong interpretations as to a tumor infiltration. Nevertheless, the transurethral sonography is an essential enlargement of the hitherto scanty spectre of the T-classification of the carcinoma of the urinary bladder. Supplementing the computer tomogram, the method brings the operator a quick survey of a possible infiltration of the wall of the bladder and a perivesical growth of the tumour. In deeply infiltrating, not radically resectable carcinomas in many cases an extensive staging-TUR may thus be avoided.