Expectant Management of Low-Risk Bladder Cancer

Patients with one or more low-grade bladder tumors of the urinary bladder will often develop a subsequent tumor but these so called “recurrences” are almost always of similar grade and rarely invade beyond the basement membrane. Therefore, the clinician should try to minimize the morbidity associated with treating these new tumors. Since many of these patients are elderly or have comorbidities, active surveillance is a very reasonable initial approach if these tumors are very small and appear low-grade. Another alternative is fulguration in the outpatient setting using a flexible cystoscope and electrode. The goal is to try to avoid the hospital and performing a formal transurethral resection. This adds potential morbidity, inconvenience, and cost.