title: The value of a second transurethral resection in evaluating patients with bladder tumours.
abstract: 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.
authors.affiliation: Department of Urology, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France.
authors.forename: Makram
authors.initials: M
authors.lastname: Miladi
authors.forename: Michaël
authors.initials: M
authors.lastname: Peyromaure
authors.forename: Marc
authors.initials: M
authors.lastname: Zerbib
authors.forename: Djillali
authors.initials: D
authors.lastname: Saïghi
authors.forename: Bernard
authors.initials: B
authors.lastname: Debré
mesh_terms: 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*