THE VALUE OF SECONDARY TRANSURETHRAL RESE CTION FOR SUPERFICIAL BLADDER-TUMORS

With a recurrence rate of 60 to 70 % for superficial urothelial carcin oma of the bladder, complete transurethral resection is the basis of s uccessful treatment. Single and differentiated resection, as well as s econdary resection, are performed in these cases. We evaluated the imp act of secondary resection (sec. TUR) by analysing 159 of our own case s. In an above-average occurrence of Tl tumors (48 %) revealed by prim ary resection, malignancy was found in 32 % by sec. TUR 4 to 6 weeks l ater. Carcinoma in situ (38 %), G3 (63 %) and multilocular (45 %) tumo rs, in particular, proved malignant in sec. TUR. The quality of primar y resection was confirmed by the fact that secondary resection reveale d only 1 out of 50 malignant tumors at the infiltrating T1 stage. In 9 cases, cis was only disclosed after sec. TUR. Comparable results foun d in the literature confirmed a malignancy rate of 18 to 63 % on secon dary TUR. Arguments for performing routine secondary resection are: co mplete resection of the tumor to prevent ''early'' recurrence of resid ual tumors; improved conditions for commencement of chemoprophylaxis; and the detection of cis in order to precisely determine prognosis and plan adequate therapy.