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Among the patients who underwent outpatient cystoscopy
as a follow up of bladder cancer, quite a few patients are observed tiny papillary
lesions suspicious for tumor recurrence. Transurethral biopsy and/or resection
under spinal or general anesthesia in a hospitalized setting are the usual
procedures for this kind of patients, even though these procedures are simple
and brief. We tried transurethral biopsy and fulguration as a treatment for
very small bladder tumor in an outpatient setting and here describe tips for
these procedures. Olympus CYF-VA flexible cystoscope, a 3 Fr. diathermy probe,
monopolar electrosurgical unit were used. No additional anesthetics except for
10 ml of 2% Xylocaine gel applied to (male patient’s) urethra as an initial
flexible cystoscopic procedure, was required for tumor treatment. Distilled
water was used as an irrigation fluid. Experienced tips of the procedures
to avoid tumor recurrence are as follows: tumor should be one location, size of
the tumor should be less than 5 mm,
bladder should be washed several times after the fulguration with hundreds ml
of distilled water. We conclude that outpatient biopsy and fulguration for tiny
bladder tumor is effective and less invasive procedure as a treatment of
bladder cancer patients.
We encountered a
63-year-old male with a sarcomatoid carcinoma of the penis accompanied by
metastasis to the bilateral inguinal lymph nodes and lungs. He noticed a penile
mass, but neglected it. The mass rapidly increased in size, forming an ulcer,
and began to disintegrate. He visited our hospital 4 months after noticing the
mass. After cystostomy and blood transfusion, surgical resection was performed.
A diagnosis of a squamous cell carcinoma with a sarcomatoid carcinoma of the
penis was made. After the operation, best supportive care (BSC) was selected.
We made efforts to maintain his quality of life (QOL), and he died 3 months
after the operation.