Tips for Office-Based Transurethral Biopsy and Fulguration as a Treatment of Tiny Bladder Tumors

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.