Transurethral resection of bladder tumors under local anesthesia

More than two thirds of urothelial bladder tumors are of small or intermediate size and of low grade. These lesions are treated mostly with transurethral resection. To reduce trauma to patients and the costs for medical care, we have evaluated if such tumors could be excised using topical anesthesia of the urethra supplemented with infiltration of a local anesthetic into the tumor base and bladder wall. In 104 of 125 resections the patients experienced little or no pain. A new fine-caliber cystourethroresectoscope has greatly facilitated the anesthetic and surgical procedures.