Role of Repeat Transurethral Resection of Bladder Tumours after Primary Resection: A Retrospective Cross-sectional Study

Abstract

Introduction: Bladder Cancer (BC) is the second most common cancer of the urinary tract. Initial treatment by Transurethral Resection of Bladder Tumour (TURBT) helps guide treatment. In High Grade (HG) and invasive cancers, improved staging is achieved by performing a repeat (rTURBT). Aim: To examine the outcome, residual disease, complications, outcomes and quality of procedure of repeat TURBTs at the study tertiary center. Materials and Methods: This was a retrospective study conducted at the Department of Urology in Government Medical College, Srinagar, Jammu and Kashmir, India between October 2018 and December 2019. A total of 123 TURBT’s were performed during the study period, of which 34 were repeat TURBT’s. Case records were examined for each of these patients. Student t-test and Chi-square tests were used to compare data sets. Results: Data was complete for 30 out of 34 patients. There was residual disease in 12 (40%) patients. Upstaging was seen in 2/12 (17%) of patients, down-staging in 0/12, and same stage in 10/12 patients (83%). No disease was seen in 18/30 (60%) of patients. No major surgical complications occurred. In 12 patients of non-invasive, High Grade (HG) tumours, who underwent rTURBTs, 6 (50%) were found to have residual disease. Conclusion: rTURBTs should be performed in all patients with high-grade or T1 tumours. Further studies are required to analyse risk-factors for residual disease which may narrow the indications of rTURBT, thus saving time and costs, and reducing need for an additional procedure.