[Carcinoma in situ of the urinary bladder: a diagnostic and therapeutic challenge]

Carcinoma in situ (Tis) of the urinary bladder means a challenge for the urologist, because of the uncharacteristic symptoms and the various treatment modalities. Early detection requires wide use of urinary cytology and multiple cold-cup biopsies. Cytology has proven to be sensitive in 95%. Histological grading of the Tis and the concomitant overt tumor is in accordance in 85%. A dedifferentiation of the tumor during the course of the disease was observed in only 14%. Modes of conservative treatment can achieve long-lasing tumor control or remission. Therefore, a cystectomy cannot be justified as the primary treatment in any case.