[Cystectomy or transurethral resection in the treatment of bladder carcinoma]

136 patients with carcinoma of the bladder were followed up after cystectomy and ileal conduit (n = 50), and TUR with post-operative irradiation (n = 86) with betatron (n = 35) or telecobalt (n = 51). The 3-year survival rate after cystectomy was 40% for all stages, the early mortality rate was around 14%. The complication rate was 16%. In the second half the survival rate was improved to 69.2% and the early mortality rate was lowered to 7.9%. After TUR and irradiation the 3-year survival rate was 48% for all stages, whereby 41% of the survivors or 20% of all patients had no further recurrence of tumours. Understaging with questionable removal in the healthy person and high persistence and recurrence are the methodic limits to TUR; a high early mortality rate and secondary late complications are the burden of cystectomy, besides psychological factors. Indications and results are discussed on the basis of the literature and an individual approach is recommended.