Discuss and analyze a surgical technique for performing a transurethral resection of bladder tumor.
Identify emerging techniques for the endoscopic management of bladder cancer.
Explain how to obtain upper tract biopsies, and laser ablations of abnormal lesions.
Identify how gemcitabine can be incorporated into the endoscopic management of upper and lower tract TCC.
Describe the data behind and how to give MitoGel in an office-based practice.
For urothelial carcinoma of the lower tract endoscopic management is the cornerstone of appropriate diagnostic and often therapeutic management for this disease. Transurethral resection of bladder tumors (TURBT) remains the primary treatment of this disease and largely unchanged for many decades in direct contrast to changes that have occurred in most other surgical aspect of urology. In this course we will start with a review of the fundamental technique, steps and approach to TURBT. We will demonstrate in videos and with audience feedback and crowdsourcing how to improve technique. We will discuss challenging cases (penile prosthesis, artificial urinary sphincters, large median lobe, very large bladder tumors, concurrent transurethral resection of the prostate [TURP]), and tips and tricks to the lynchpin many urologists practice with the goal of improving skills of a procedure many do day in and day out. We will discuss how to get the most out of your pathology and pathologist as well as interpreting variant histology. From there we will move into novel approaches to TURBT with the incorporation of lasers and hydrodissection and methods utilizing non-white light cystoscopy as an adjunct to improve traditional endoscopic TURBT.
From there we will move to the upper tract. We will review endoscopic management of upper tract urothelial carcinoma and review how to get an adequate specimen. We will highlight various approaches and techniques, as well as endoscopic tools. We will also review and demonstrate laser ablation, MitoGel™ and use of gemcitabine for upper tract transitional cell cancer (TCC).