Bladder cancer (uroepithelial carcinoma) has a multicentric occurrence; therefore, after standard treatment of early bladder cancer, it is possible that new tumors may be found again in the future elsewhere in the bladder.
More than 70% of initially detected or diagnosed bladder cancers are non-muscle invasive (previously called superficial) tumors. After electrodesection of these bladder tumors using endoscopy via the urethra and treatment with intravesical instillation, about 50% of patients will have recurrence of bladder tumors and about 20% of patients will have tumors that progress to muscle invasive tumors.
Cystoscopy allows for timely detection of microscopic lesions and pathologic biopsy for laboratory testing. Although a number of painless tests are now available for the diagnosis and detection of bladder cancer, none are as accurate as cystoscopy.
There are two types of cystoscopy: rigid and flexible, and there are two types of anesthesia: mucosal surface anesthesia and lumbar anesthesia. Generally, soft cystoscopy is less painful and can be done with mucosal surface anesthesia, which is simple and convenient. With rigid cystoscopy, mucosal surface anesthesia is more painful and lumbar anesthesia is better but more costly.