In this article, we will talk about the treatment of bladder tumor that has not spread to the muscle layer.
In patients suspected of having bladder cancer, an endoscopic resection of the tumor should be performed as a diagnostic procedure and first step in treatment, followed by pathological examination of the obtained sample(s).
Fulguration or laser vaporization of small papillary recurrences can be used in patients with a history of tumors in the bladder mucosal layer. Endoscopic examination of the urinary tract should be performed first, followed by a systematic examination of the bladder. In the meantime, a biopsy should be taken from suspected points.
When the bladder is reached, the location, size and structure of the tumor should be observed and noted. Then the tumor must first be resected superficially and placed in a special pathology container. Then the tumor base should be taken together with the muscle tissue under it and placed in a separate pathology container. The tumor can be resected en bloc with the underlying muscle tissue layer. Bleeding control should be ensured after the resection procedure. In low and medium risk patients, administration of a single dose of repirubicin into the bladder within 2 hours at the earliest or within 24 hours at the latest reduces the likelihood of recurrence.
Follow up
Endoscopic follow-up should be performed at regular intervals in tumors that have not spread to the muscle layer.
Patients with low-risk Ta tumors should undergo cystoscopy at 3 months. If negative, the next cystoscopy is recommended after 9 months and then annually for 5 years.
Patients with high-risk and very high-risk tumors treated conservatively should undergo cystoscopy and urinary cytology at 3 months. If negative, subsequent cystoscopy and cytology should be repeated every 3 months for 2 years, then every 6 months until age 5, and annually thereafter.
Regular (annual) upper system imaging (computed tomography or intravenous urography) is recommended for high-risk and very high-risk tumors.In patients initially diagnosed with low-risk bladder cancer that has not spread to the muscle, ultrasound of the bladder and/or a urinary marker may be used during follow-up if cystoscopy (endoscopy) is not possible or is rejected by the patient.
Bladder cancer treatment is a type of urological cancer that should not be delayed. must be followed and treated.
I will publish the treatment of bladder cancer that has spread to the muscle in our next article.
