The value of a second transurethral resection in evaluating patients with bladder tumours.
OBJECTIVE
To evaluate the usefulness of a second transurethral resection for superficial and muscle-invasive bladder tumours.


METHODS
A review of the literature relevant to repeat resection for bladder tumours was conducted using Medline Services.


RESULTS
Transurethral resection of the bladder has two shortcomings: underestimating clinical stage, and overlooking other lesions. A second transurethral resection, when performed 2-6 weeks after the initial resection, corrects clinical staging errors in 9-49% of cases and detects residual tumour in 26-83% of cases. A second resection is particularly warranted for T1 tumours since 2-28% of them prove to be muscle-invasive, thus requiring a change in management. For muscle-invasive tumours, a second resection may be performed only if bladder sparing is being considered, as it helps to exclude the presence of tumour sites contra-indicating conservative treatment.


CONCLUSIONS
A second transurethral bladder resection may be warranted for T1 tumours, and for invasive tumours when a bladder preservation is planned.
Miladi
Makram
M
Department of Urology, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France.
Peyromaure
Michaël
M
Zerbib
Marc
M
Saïghi
Djillali
D
Debré
Bernard
B
D015653:Cystectomy / Q000379:methods; D004724:Endoscopy; D006801:Humans; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012086:Reoperation; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*