Page 211 - Urological Health

Table 2.Tumour (T) staging of bladder cancer

Tx Primary tumour cannot be assessed
Ta Non-invasive papillary carcinoma
Tis Carcinoma in situ
T1 Tumour invades lamina propria (subepithelial connective tissue)
T2 Tumour invades muscularis propria
T2a Invades superficial muscularis propria (inner half)
T2b Invades deep muscularis propria (outer half)
T3 Tumor invades perivesical tissue/fat
T3a Microscopically
T3b Macroscopically (extravesical mass)
T4 Tumour invades: prostate, seminal vesicles, uterus, vagina, pelvic or abdominal wall
T4a Invades prostate, seminal vesicles, uterus or vagina
T4b Invades pelvic or abdominal wall

UNDER REVIEW
Treatment

1.TURBT

As mentioned earlier, TURBT is done to diagnose and to treat bladder cancer. It is essential that all
visible tumours be resected during surgery, and it’s especially important that this resection includes
a muscle layer. In some cases where no muscle is seen on initial pathology, your urologist may opt for
a re-resection to accurately determine your stage and give you the best possible treatment. In some
cases of Ta or T1 high-grade disease where benign muscle is found on final specimen, your urologist
may still insist on a re-resection for more accurate staging and better treatment selection.
In addition to resecting all visible tumors, all suspicious areas that look“velvety” or abnormally red
or boggy must also be resected or burned using the resectoscope. After the surgery, a urinary catheter
is usually kept in place so that your urine drains into a bag. This catheter may be used to administer
medications into your bladder after your surgery. These medications can help to destroy “floating”
tumour parts and decrease the chance of the tumour coming back.The catheter is often kept overnight
until the urine colour clears up, after which the catheter is removed. You may experience some
discomfort and burning upon urination after the surgery. This may last a couple of weeks.

After a TURBT, you will have a raw surface that is eventually covered with normal cells.
You may have blood clots and debris up to four weeks after surgery.

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