Transurethral en bloc resection of bladder tumors

Purpose: Transurethral en bloc resection of bladder tumors is desirable for evaluating the pathological depth of bladder tumors in resected specimens. The safety, technique and effectiveness of en bloc resection of bladder tumors was investigated using a holmium laser or knife electrode. Materials and Methods: A total of 35 patients with transitional cell carcinoma of various sizes underwent transurethral en bloc resection with the muscle layer by holmium laser or knife electrode. The holmium laser was used for tumors at the bladder neck, as in prostate resection, while tumors at the bladder wall were treated with a knife electrode. A circular incision was made around the tumor, followed by level incisions beneath it with subsequent tumor retrieval. The circular incision connected marks made about 10 mm. away from the tumor edge and continued until the superficial muscle layer was visualized. The resected 1 piece specimen was grasped with a loop electrode and retrieved. Results: This technique has been used in 35 consecutive patients (50 lesions). Tissue slides crossing the center of the tumor correctly determined the depth of cancer invasion as stages pTa to pT2. No uncontrollable bleeding, perforation or other serious complications occurred. Conclusions: Transurethral en bloc resection is a safe and useful technique that also provides sufficient material for pathological evaluation.