title: NBI cystoscopy and bipolar electrosurgery in NMIBC management - An overview of daily practice.
abstract: BACKGROUND
  The standard non-muscle invasive bladder cancer (NMIBC) endoscopic diagnosis suffers from the frequently unsatisfactory white light evaluation accuracy leading to residual lesions being left behind. Monopolar transurethral resection of bladder tumors (TURBT) is marked by a substantial morbidity rate requiring further amelioration.
  
  
  METHODS
  Small size tumors (under 1 cm) are feasible for "en bloc" resection. Bipolar TURBT was defined as being able to challenge the gold-standard status of monopolar resection due to the reduced complication rates. Plasma-button vaporization was introduced as a promising large bladder tumors' ablation modality. Narrow band imaging (NBI) cystoscopy became an increasingly popular method of enhancing tumor detection.
  
  
  RESULTS
  The "en bloc" resection of small size or thin pedicle tumors provides the conditions for avoiding tumoral tissue scattering. Bipolar resection is characterized by decreased perioperative bleeding risks and faster patient recovery. Plasma-button vaporization gained confirmation as an innovative approach, able to dispose large tumor bulks under complete control while minimizing the associated morbidity. NBI cystoscopy is a useful tool in identifying CIS lesions, small papillary tumors or extended margins of large tumor formations. As a cost-free technique, it may be extensively used both during the NMIBC initial diagnostic as well as during follow-up evaluation protocol.
  
  
  CONCLUSIONS
  Having in mind the various modalities of ameliorating the bladder cancer diagnostic and treatment, NMIBC management should be tailored in accordance with the particularities of each case.
authors.affiliation: Sf. Ioan Clinical Emergency Hospital, Department of Urology, Bucharest, Romania. bogdan_geavlete@yahoo.com
authors.forename: B
authors.initials: B
authors.lastname: Geavlete
authors.forename: F
authors.initials: F
authors.lastname: Stănescu
authors.forename: C
authors.initials: C
authors.lastname: Moldoveanu
authors.forename: M
authors.initials: M
authors.lastname: Jecu
authors.forename: L
authors.initials: L
authors.lastname: Adou
authors.forename: C
authors.initials: C
authors.lastname: Bulai
authors.forename: C
authors.initials: C
authors.lastname: Ene
authors.forename: P
authors.initials: P
authors.lastname: Geavlete
mesh_terms: D003558:Cystoscopy / Q000379:methods*; D004598:Electrosurgery / Q000379:methods*; D006801:Humans; D001749:Urinary Bladder Neoplasms / Q000601:surgery*
keywords: NBI cystoscopy; bipolar TURBT; plasma-button vaporization; “en bloc" resection
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