immediately before operation
immediately before incision and post-operative for 1 day
immediately before incision and post-operative for 15 days
immediately before incision and post-operative for 30 days
D. immediately before incision and post-operative for 30 days
tumor stage
tumor grade
lymphovascular invasion
lymph node spread
2 - 4%
4 - 6%
6 - 8%
8 - 10%
40 - 55%
55 - 70%
70 - 85%
85 - 100%
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
30%
40%
50%
60%
undergo cystectomy
try mitomycin c
take a second course of BCG
take a second course of BCG + quinolones
the lesion is solitary and no associated CIS
physically, a surgical margin of 2-cm can be obtained
the resected area should be far enough from ureteral orifices and the bladder neck
all of the following
continue the procedure as perforations at this site do no harm
abort the procedure and leave a urethral catheter
convert tumor removal to open method and repair the defect
perform abdominal exploration and manage accordingly
leiomyosarcoma
rhabdosarcoma
carcinosarcoma
neurosarcoma
increase the irrigation fluid and pursue the procedure
abort the procedure and leave a urethral catheter
perform cystogram and manage accordingly
perform abdominal exploration and manage accordingly
transitional cell carcinoma
squamous cell carcinoma
adenocarcinoma
small cell carcinoma
irritative bladder symptoms
obstructive bladder symptoms
palpable suprapubic mass on physical examination
painless profuse hematuria
well-differentiated tumor with broad-based invasive font
marked atypia distributed on wide areas of superficial urothelium
atypia is present
no atypia but marked degenerative epithelial changes
patients with carcinoma in situ
patients with completely resected solitary tumor
patients with preserved kidney and liver functions after 2 courses of BCG
patients with leiomyosarcoma
only in females
associated with chronic irritation, polypoid cystitis, and cystitis glandularis
no risk for squamous cell carcinoma
treated with estrogen, if symptomatic
immediately before operation
immediately before incision and post-operative for 1 day
immediately before incision and post-operative for 15 days
immediately before incision and post-operative for 30 days
single intravesical chemotherapy
TURBT
intravesical BCG vaccine
multiple bladder biopsies
10%
20%
30%
40%
bladder perforation
obturator nerve reflex
vesico-ureteral reflux
terrible bleeding
rarely diagnosed at autopsy
the peak incidence occurs between ages 70 and 80
they occur twice as frequently in men as in women
none of the above
frequently found in association with high-grade or extensive TCC
has a rate of progression to muscle invasion of 10-25%
significant areas of CIS are easily missed by routine cystoscopy
treatment begins with TURBT
0.6 - 2%
2 - 6%
6 - 10%
12 - 16%
nodular or sessile lesions usually invade muscle
papillary bladder tumors are typical of low stage and grade
carcinoma in situ appears as a flat, velvety patch
sarcomas commonly invade bladder base and ureteral orifices causing obstructions
sensitivity to chemotherapy and age at presentation
anatomic location and extent of the tumor
histologic type of the tumor and sensitivity to radiotherapy
tumors stage and grade
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
infiltrative proximal penile urethral carcinomas
infiltrative distal penile urethral carcinomas
recurrent proximal penile urethral carcinoma after laser resection
T3/N2/M0 at bulbar urethra
often of high-grade sarcomas
often associated with muscularis propria invasion
due to vesical polyps occluding ureteric orifices
should be resected but not diathermized
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
comparable
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
there will be no target tumor tissue to work on
post-op. hematuria interacts unfavorably with BCG composition
of the risk of systemic absorption and sepsis
of the high risk of BCG reflux to kidneys while bladder irrigation