Frank Waldbillig1,2, Simon Hein2,3, Britta Grüne1,2, Rodrigo Suarez-Ibarrola2,3, Evangelos Liatsikos4, Georg Salomon5, Alexander Reiterer2,6,7, Christian Gratzke3, Arkadiusz Miernik2,3, Maximilian C Kriegmair1,2, Manuel Ritter2,8. 1. Department of Urology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany. 2. RaVeNNA 4pi-Consortium of the German Federal Ministry of Education and Research (BMBF), Mannheim, Germany. 3. Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, Freiburg, Germany. 4. Department of Urology, University Medical Center Patras, Patras, Greece. 5. Martini Clinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 6. Fraunhofer Institute for Physical Measurement Techniques, Freiburg, Germany. 7. Department of Sustainable Systems Engineering INATECH, University of Freiburg, Freiburg, Germany. 8. Department of Urology and Pediatric Urology, University Medical Center Bonn, University of Bonn, Bonn, Germany.
Abstract
Purpose: The aim of this survey was to obtain an overview of current European standards in the endoscopic visualization and management of bladder tumors. Methods: An online survey was launched in July 2018 for a duration of 4 months. It was distributed to all members of the European Association of Urology (EAU) and included 23 questions divided into 3 thematic sections: general information, white light cystoscopy (WLC) and imaging, and transurethral resection of bladder tumor (TURBT) techniques. Results: Responses of 222 participants were included for analysis. The majority of physicians were between 30 and 40 years of age (48.2%, n = 107) and performed over 50 TURBT per year (52.2%, n = 115). Overall, 52.3% (n = 116) reported WLC findings in written form only, 23.8% (n = 53) added endoscopic footage, and 79.2% (n = 176) considered preliminary WLC/TURBT reports before performing a subsequent bladder intervention. About half of the participants (50.5%, n = 104) used additional tumor visualization methods (aTVMs), but aTVMs were utilized by a greater proportion of physicians from Western countries (58.1%, n = 90) compared with developing countries (20.0%, n = 7). Photodynamic diagnosis was the predominant aTVM technique employed (43.8%, n = 60). Bipolar current was the most common technique for TURBT (46.6%, n = 149). Most urologists in this study occasionally utilized techniques like resections in fractions (80%, n = 161) or en bloc resection (87.2%, n = 182). A repeated TURBT was performed when no muscle was found in the specimen (70.6%, n = 149) and/or if the tumor was stage pT1 (72.0%, n = 152) or high grade (63.0%, n = 133). Conclusion: Implementation of resection techniques or repeated TURBT within EAU guidelines is promising, but it can be further challenged. For example, WLC/TURBT reporting should be improved since urologists consistently consider previous documentation. Given the moderate application rate of aTVMs, an attempt to increase its utilization would lead to a better assessment of its potential benefit.
Purpose: The aim of this survey was to obtain an overview of current European standards in the endoscopic visualization and management of bladder tumors. Methods: An online survey was launched in July 2018 for a duration of 4 months. It was distributed to all members of the European Association of Urology (EAU) and included 23 questions divided into 3 thematic sections: general information, white light cystoscopy (WLC) and imaging, and transurethral resection of bladder tumor (TURBT) techniques. Results: Responses of 222 participants were included for analysis. The majority of physicians were between 30 and 40 years of age (48.2%, n = 107) and performed over 50 TURBT per year (52.2%, n = 115). Overall, 52.3% (n = 116) reported WLC findings in written form only, 23.8% (n = 53) added endoscopic footage, and 79.2% (n = 176) considered preliminary WLC/TURBT reports before performing a subsequent bladder intervention. About half of the participants (50.5%, n = 104) used additional tumor visualization methods (aTVMs), but aTVMs were utilized by a greater proportion of physicians from Western countries (58.1%, n = 90) compared with developing countries (20.0%, n = 7). Photodynamic diagnosis was the predominant aTVM technique employed (43.8%, n = 60). Bipolar current was the most common technique for TURBT (46.6%, n = 149). Most urologists in this study occasionally utilized techniques like resections in fractions (80%, n = 161) or en bloc resection (87.2%, n = 182). A repeated TURBT was performed when no muscle was found in the specimen (70.6%, n = 149) and/or if the tumor was stage pT1 (72.0%, n = 152) or high grade (63.0%, n = 133). Conclusion: Implementation of resection techniques or repeated TURBT within EAU guidelines is promising, but it can be further challenged. For example, WLC/TURBT reporting should be improved since urologists consistently consider previous documentation. Given the moderate application rate of aTVMs, an attempt to increase its utilization would lead to a better assessment of its potential benefit.
Authors: M C Kriegmair; S Hein; D S Schoeb; H Zappe; R Suárez-Ibarrola; F Waldbillig; B Gruene; P-F Pohlmann; F Praus; K Wilhelm; C Gratzke; A Miernik; C Bolenz Journal: Urologe A Date: 2020-12-10 Impact factor: 0.639
Authors: S O'Sullivan; M Janssen; Andreas Holzinger; Nathalie Nevejans; O Eminaga; C P Meyer; Arkadiusz Miernik Journal: World J Urol Date: 2022-01-27 Impact factor: 3.661