Technique of TUR of Bladder Tumours: Value of Repeat TUR and Random Biopsies

Of all the patients who present with bladder cancer, approximately 75–85% present with disease confined to the mucosa (stage Tis carcinoma in situ [CIS] or stage Ta) or submucosa (stage T1). These groups of bladder cancer are referred to as non–muscleinvasive or superficial bladder cancer, in contrast with muscle-invasive bladder cancer (stage T2, or advanced stage T3–T4). These anatomic classifications are based on the tumour-node-metastases (TNM) classification of 2002, which was approved by the Union International Contre le Cancer (UICC) [1]. At the start of the new millennium, the histologic grading of non–muscle-invasive bladder cancer is still based on a World Health Organization (WHO) classification system from 1973. Although a new classification of noninvasive urothelial tumours was proposed by the WHO and the International Society of Urological Pathology (ISUP) in 1998 and published in 2004, this new classification system is yet to be validated in more clinical trials [2,3]. In contrast with the 1973 WHO classification, in the 2004 WHO classification the disputed intermediate (moderately differentiated) group is eliminated [4].