Can we improve transurethral resection of the bladder tumour for nonmuscle invasive bladder cancer?

The recurrence rate in patients with nonmuscle invasive bladder cancer is high, and the quality of transurethral resection of the bladder (TURB) tumour influences recurrence risk. We review new methods that aim to improve the effectiveness of TURB, and highlight studies of the past year.

Several approaches have been explored: bipolar resection is well tolerated and efficient; however, surgical outcomes are not clearly superior to monopolar resection; en-bloc resection seems feasible and well tolerated, and has the potential to improve the quality of tissue for histopathology; enhancement techniques such as photodynamic diagnosis, narrow band imaging, and Image1 S improve tumour detection, whereas photodynamic diagnosis reduces recurrence rates; high-resolution imaging modality such as confocal laser endomicroscopy may provide histopathologic information. Additionally, optical coherence tomography, Raman spectroscopy, multiphoton microscopy and ultraviolet autofluorescence microscopy, molecular imaging, and photoacoustic imaging are techniques that are in development.

Recent advances in resection methods and image enhancement techniques have been studied to improve the quality of TURB, but more evidence is still needed before these techniques can be implemented in daily practice.

Current opinion in urology. 2016 Dec 09 [Epub ahead of print]

Esmee Iml Liem, Theo M de Reijke

Department of Urology, Academic Medical Center, Amsterdam, The Netherlands.