Transurethral resection of bladder tumour (TURBT)

Lawrence H C Kim, Manish I Patel, Lawrence H C Kim, Manish I Patel

Abstract

The goals of transurethral resection of bladder tumour (TURBT) are to identify and eradicate visualized bladder tumour if technically safe and feasible and to obtain a specimen of satisfactory quality to enable accurate histological diagnosis. In the setting of high grade bladder tumour this generally entails the inclusion of detrusor muscle and assessment for the presence of associated carcinoma in situ (CIS), lymphovascular involvement or any variant form of bladder cancer. This will assist in determining risk stratification and prognostication of the bladder cancer and guides further treatment planning. Conversely, if suboptimal TURBT is performed there will be detrimental consequences on patient outcomes in regards to undergrading or understaging, increased recurrence or progression, and subsequently need for further treatments including more invasive interventions. This review article firstly summarises the key principles and complications of TURBT, as well as significance of re-TURBT. We also discuss a number of modifications and advances in detection technology and resection techniques that have shown to improve perioperative as well as pathological and oncological outcomes of bladder cancer. They include enhanced cystoscopy such as blue light cystoscopy (BLC), narrow band imaging (NBI) and en bloc resection of bladder tumour (ERBT) technique using various types of energy source.

Keywords: Transurethral resection of bladder tumour (TURBT); blue light cystoscopy (BLC); carcinoma in situ (CIS); en bloc resection of bladder tumour technique (ERBT technique); narrow beam imaging (NBI); non-muscle invasive bladder cancer (NMIBC).

Conflict of interest statement

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tau.2019.09.38). The series “Surgery for Urologic Cancers” was commissioned by the editorial office without any funding or sponsorship. The authors have no other conflicts of interest to declare.

2020 Translational Andrology and Urology. All rights reserved.

Figures

Figure 1
Figure 1
Bladder diagram [permission obtained from the EAU guidelines (36)].

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