Perioperative chemotherapy refers to the practice of instilling one of the bladder chemotherapies immediately after TURBT, usually while you are still in the operating room or the recovery room. Traditionally, these intravesical therapies have been given after the bladder has healed, 2 to 3 weeks after surgery. Several studies in the last 10 years have [...]

TURBT is generally regarded as a low-risk procedure. It is typically performed as a  day surgery procedure, meaning that you will not need to stay in the hospital overnight. As with any surgery that requires anesthesia, a small risk is associated with the anesthesia. This risk is higher if you have other conditions such as [...]

TURBT stands for transurethral Resection of a Bladder Tumor. It requires a specialized type of cystoscope that has been modified to include a mechanism to cut out bladder tumors. This specialized scope is called a resectoscope and is inserted the same way as a cystoscope. A wire loop is attached that can be extended back [...]

Sometimes you may feel that it is necessary to get a second opinion. You may have concerns about the treatment recommendations or may worry that there are other options that have not been presented. If you ever feel that you have not received enough information or that you are uncomfortable with the treatment recommendations from [...]

Once you have been diagnosed with invasive bladder cancer, you should try to select a urologist and oncologist who deal with bladder cancer on a regular basis. Several issues should be considered when you select a physician. Competence: You need a capable doctor who is knowledgeable and can apply that knowledge. Technical skills: If you [...]

Although cytology has long been the gold standard for bladder cancer screening, including monitoring for recurrences, it is far from perfect (see Question 33), and there is great interest in finding an even better test. Currently, at least four other markers are approved by the Food and Drug Administration (FDA), although none of them are [...]

Do I Need To Worry? This is what is usually called a “false-positive” test result. The test was positive in a case where it seems that it should have been negative. Any medical test has a certain false-positive rate (usually very low). The problem with a false-positive result with urine cytology is that there is [...]

Urine cytology is commonly used to screen for bladder cancer in patients who have hematuria as well as to monitor for recurrences in patients who are being treated for bladder cancer. Overall, urine cytology is able to detect 40% to 60% of bladder cancers, but the ability of cytology to detect a tumor varies depending [...]

Carcinoma in situ can be difficult to see during a routine cystoscopy. Your urologist may take random biopsies of the bladder and send them to pathology, hoping to catch the area that has carcinoma in situ. New technology is available that uses fluorescent lighting through the cysto-scope to help identify areas suspicious for carcinoma in [...]

“Upper tract studies” are evaluations that your doctor does of your kidneys and ureters. The lining of the bladder is the urothelium. The same urothelium also lines the ureters and the inside of the kidneys. The kidneys and the ureters are then also potential locations of transitional cell cancer. The study that your doctor chooses [...]

In addition to determining the grade of the tumor, the pathologist will determine the stage of the tumor, which refers to the extent of the cancer and therefore the chances that it has spread beyond the bladder. The pathologist looks at how deep the tumor invades into the bladder wall. If the cancerous cells are [...]

The pathologist grades a tumor based on how the cells look under the microscope. The tumor cells can appear close to normal (low grade) or more aggressive and angry (high grade). As you might expect, low-grade tumors tend to have a better prognosis than high-grade tumors. Most pathologists grade tumor biopsies as I, II, and [...]

Is This Normal? What Can I Do To Get Back To The Way I Used To Be? The diagnosis of bladder cancer comes as a shock to most individuals. In most individuals, the only symptom/sign of bladder cancer is blood in the urine. Those individuals with gross hematuria (bright red blood in the urine) are [...]

Each individual is different, and each relationship is different; thus, it is hard to generalize about how each of you and the two of you together will react. In general, there are different aspects of bladder cancer and its treatment that are more stressful for you and your spouse or partner. Men generally are most [...]

An important part of your doctor’s evaluation for hematuria is cystoscopy, either in the office or in the operating room. Sometimes your doctor can tell just by looking at your bladder wall through the cystoscope that there is a tumor that needs to be resected in the operating room . Other times, there will be [...]

A pelvic exam is an important part of evaluating bladder cancer, and all women should have a proper pelvic exam during the initial visit. The pelvic exam helps to determine the stage of the tumor. Your doctor places one hand on your abdomen and the other into the vagina during the exam. This enables him [...]

Cystoscopy refers to the direct visual examination of the inside of the bladder using a small telescope called a cystoscope. The cystoscope has a light at the tip to illuminate the bladder. There is a channel through which water flows and fills the bladder, stretching it out to allow better visualization. The cystoscope is inserted [...]

Most patients who are being evaluated for bladder cancer are referred because of gross or microscopic blood in the urine. Others may have irritative voiding symptoms such as frequency, urgency, or pain. Finally, some may have a positive urine cytology test or a mass detected on a CT scan that was obtained for some other [...]

Gross hematuria (visible blood in the urine) can be caused by several things other than cancer. A urinary tract infection, a kidney stone, a bladder stone, chronic irritation in the bladder, many kidney diseases, and other less common conditions all can cause hematuria. Men with large prostates who strain to void may get bleeding because [...]

One of the most common  signs of bladder cancer is blood in the urine (hematuria). In the majority of cases, this includes microscopic amounts of blood that can only be picked up by the laboratory on a urine sample. Some people will have so much bleeding that it turns the urine pink or red (gross [...]