What is the role of biopsy in the diagnosis of bladder cancer?

Updated: Nov 27, 2016
  • Author: Michael Christopher Large, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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  • Biopsy - Transurethral resection of bladder tumor

    • The biopsy consists of cystoscopic resection of tumors with biopsy forceps or a resectoscope. Superficial-appearing papillary tumors, as assessed by an experienced urologist, are virtually always noninvasive lesions. As a rule, any lesion that may extend into the lamina propria or deeper should include deep resection specimens that incorporate muscularis propria.

    • The biopsy can be performed in an operating room under general or spinal anesthesia.

    • The site, size, and number of tumors and whether papillary tumors are sessile, solid, nodular, or pedunculated is documented.

    • A biopsy of the prostatic urethra may be considered in patients at high risk for urethral disease (extensive CIS, multifocal high-grade disease, disease at or near the bladder neck, an abnormal-appearing prostate); 10%-40% of patients with bladder cancer have prostatic urethral involvement.

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