Active Surveillance vs in Office Fulguration for Low Grade Bladder Cancer Tumors

Prospective Randomized Trial in Low Grade Bladder Tumors: Active Surveillance vs Endoscopic Fulguration.

Biological behabiour of low grade bladder cancer tumors is well known. They have a very high rate of recurrences during their follow up but very low (less than 1%) risk of progression.

Until now, the gold standard of any bladder recurrence for this patients is performing an immediate transurethral ressection of the tumor.

This surgery has risk of complications and, due to the low risk of these subgroup of tumors, sometimes it becomes an overtreatment for the patients.

This is the reason why new conservative or less invasive surgeries are proposed to follow up and treat these patients.

Inclusion Criteria:

• Recurrent Ta-T1a (above muscularis mucosa) LOW GRADE bladder tumor
• Accept cystoscopy surveillance
• Main lession less than 10mm
• Less than 7 lesions
• Negative or low grade cytology
• No solid aspect

Exclusion Criteria:

• previous High grade bladder cancer tumors
• previous Cis
• previous Upper Urinary Tract tumor
• previous pelvic radiotherapy
• hematuria
• meatal localisation