086IC - Revisiting Endoscopic Management of Urothelial Tumors

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).