Repeated Transurethral Resection of Recurrent Superficial Bladder Tumors: Does it Affect the Spread and Stage of the Tumor?

Abstract

We conclude that some malignant cells penetrate through the denuded urothelium during TURT by the effect of high intravesical pressure. This may be responsible, among other factors, for tumor recurrence with deeper stages.

Outcome of Simultaneous Transurethral Resection of Bladder Tumor and Transurethral Resection of the Prostate in Comparison with the Procedures in Two Separate Sittings in Patients with Bladder Tumor and Urodynamically Proven Bladder Outflow Obstruction

“…[11][12][13][14][15] The presumed pathways for this dissemination are extravasation of the irrigation fluids by way of blood or lymphatic circulation and=or implantation of tumor cells at the traumatized sites because of the high intravesical pressures generated during transurethral resection. 6,7,16,17 A greater number of recurrences have been shown to develop on the posterosuperior wall, which is probably the most frequent site to be traumatized during TURBT. 10 It has been observed that bladder perforations cause a slight increase in the recurrence rates even for low-grade tumors.…”

“…[2][3][4][5] This hypothesis, however, could not be verified in several comparative studies, and the safety issue regarding transurethral resection of superficial TCC of the urinary bladder and transurethral resection of the prostate (TURP) performed in the same sitting remains controversial. [6][7][8][9] Many urologists avoid performing transurethral resection of bladder tumor (TURBT) and TURP in the same sitting because of this lack of information, with the belief that there might be implantation of tumor cells in the prostatic fossa. They, therefore, prefer to undertake separate procedures for each of these pathologic conditions.…”

“…Other urologists, however, have observed that TURBT and TURP, when combined in the same sitting, do not have any negative effect. [6][7][8][9][10] The present study was carried out with the aim of prospective evaluation of recurrence and progression of superficial, solitary, <3 cm (in diameter) bladder tumor with urodynamically proven bladder outlet obstruction from benign prostatic hyperplasia (BPH) in patients who underwent TURBT and TURP in the same sitting versus those in whom TURBT and TURP were performed as two separate operations 6 months apart in patients with superficially appearing bladder tumor. A urodynamic study was performed before TURP because one can expect high probability of relief from lower urinary tract symptoms (LUTS) if high pressure poor flow can be documented on the basis of this study.…”

Primary Invasive versus Progressive Invasive Transitional Cell Bladder Cancer: Multicentric Study of Overall Survival Rate

“…The evidence to support this theory is based on the histological findings of multifocal malignant cell clusters in the bladder of multi-TURB patients [9] . These theoretical hypotheses are difficult to prove.…”

Persistence, Recurrence, and Progression Rates of Superficial Bladder Tumours after Resection Using the Differentiated Technique

“…El-Abbady et al [11] demonstrated unusual patterns of tumour expansion in cystectomy specimens after previous transurethral resections. When transurethral resection had been performed, bladder tissues showed clusters of malignant cells in between muscle fi bres and perivesical fat.…”