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Background: A retrospective study was aimed to establish the eventual impact of narrow band imaging (NBI) cystos copy over the short term residual tumors’ rate determined during the first follow-up endoscopic control in newly determined non-muscle invasive bladder cancer (NMIBC) cases., Methods: 68 patients were found with NMIBC by means of both white light cystoscopy (WLC) and NBI. A follow-up using both investigation modalities was performed at 3 months from the initial procedure in 67 cases (one was lost from follow-up). RESULTS concerning the short termer currences were retrospectively compared to those obtain ending a similar series of 67 patients previously diagnosed and treated by means of classical WLC and resection only., Results: The short term residual tumors’ rate established during the first follow-up cystoscopy was lower in the study group initially benefiting from the NBI mode by comparison to the WLC control series (4.5% versus 11.9%). When drawing a parallel with the tumor map location outlined during the initial procedure, the most important differences were emphasized concerning other site recurrences (3%versus 8.95%)., Conclusions: NBI cystoscopy and resection displayed a substantially favorable influence over the short termoncologic outcome in newly diagnosed NMIBC cases when compared to the standard protocol., Abbreviations: NBI â€" narrow band imaging; NMIBC â€"non-muscle invasive bladder cancer; WLC â€" white light cystoscopy; TURBT â€" transurethral resection of bladdertumors; CIS â€" carcinoma in situ., (Celsius.)

Objectives: A single centre, retrospective trial was performed trying to assess the impact of NBI cystoscopy in cases of non-muscle invasive bladder tumors (NMIBT) by comparison to the standard approach. Our goal was to determine the superiority of the new method in terms of detection rates and subsequent postoperative treatment changes., Materials and Methods: A total of 320 NMIBT suspected consecutive cases were enrolled in the study. The inclusion criteria were represented by hematuria, positive urinary cytology and/or ultrasound suspicion of bladder tumors. All patients underwent WLC and NBI cystoscopy. Standard transurethral resection of bladder tumors (TURBT) was performed for all lesions visible in WL and NBI guided resection for solely NBI observed tumors., Results: The overall NMIBT and CIS patients' detection rates were significantly improved for the NBI evaluation ((94.9% versus 88.1% and 95.7% versus 65.2%). Also, on a lesions' related basis, NBI cystoscopy emphasized a significantly superior diagnostic accuracy concerning the CIS, pTa and overall NMIBT formations ((95.2% versus 60.3%, 92.8% versus 83.9% and 94.1% versus 82%). Additional tumors were diagnosed by NBI in a significantly higher proportion of CIS, pTa, pT1 and NMIBT patients (56.6% versus 8.7%, 28% versus 10.3%, 30.3% versus 10.6% and 31.6% versus 9.4%). As a result of these supplementary findings, the postoperative treatment was significantly improved in a substantial proportion of cases (15.4% versus 5.1%)., Conclusions: NBI cystoscopy represents a valuable diagnostic alternative in NMIBT patients, with significant improvement of tumor visual accuracy as well as detection rates. This approach provided a substantial amelioration to the risk category stratification and subsequent bladder cancer therapeutic management.

Objectives: A prospective study was performed aiming to evaluate the surgical efficacy, perioperative safety profile, diagnostic accuracy and medium term results of a multi-modal approach consisting in narrow band imaging (NBI) cystoscopy and bipolar plasma vaporization (BPV) when compared to the standard protocol represented by white light cystoscopy (WLC) and transurethral resection of bladder tumors (TURBT)., Materials & Methods: A total of 260 patients with apparently at least one bladder tumor over 3 cm were included in the trial. In the first group, 130 patients underwent conventional and NBI cystoscopy followed by BPV, while in a similar number of cases of the second arm, classical WLC and TURBT were applied. In all non-muscle invasive bladder tumors' (NMIBT) pathologically confirmed cases, standard monopolar Re-TUR was performed at 4-6 weeks after the initial intervention, followed by one year' BCG immunotherapy. The follow-up protocol included abdominal ultrasound, urinary cytology and WLC, performed every 3 months for a period of 2 years., Results: The obturator nerve stimulation, bladder wall perforation, mean hemoglobin level drop, postoperative bleeding, catheterization period and hospital stay were significantly reduced for the plasma vaporization technique by comparison to conventional resection. Concerning tumoral detection, the present data confirmed the NBI superiority when compared to standard WLC regardless of tumor stage (95.3% vs. 65.1% for CIS, 93.3% vs. 82.2% for pTa, 97.4% vs. 94% for pT1, 95% vs. 84.2% overall). During standard Re-TUR the overall (6.3% versus 17.4%) and primary site (3.6% versus 12.8%) residual tumors' rates were significantly lower for the NBI-BPV group. The 1 (7.2% versus 18.3%) and 2 (11.5% versus 25.8%) years' recurrence rates were substantially lower for the combined approach., Conclusions: NBI cystoscopy significantly improved diagnostic accuracy, while bipolar technology showed a higher surgical efficiency, lower morbidity and faster postoperative recovery. The combined technique offered a reduced rate of residual tumors at Re-TUR, both globally as well as for orthotopic tumors. Substantially lower recurrence rates were found at 1 and 2 years among the NBI-BPV cases.

Introduction: The standard non-muscle invasive bladder cancer (NMIBC) endoscopic diagnosis suffers from the frequently unsatisfactory white light evaluation accuracy leading to residual lesions being left behind. Monopolar transurethral resection of bladder tumors (TURBT) is marked by a substantial morbidity rate requiring further amelioration., Methods: Small size tumors (under 1 cm) are feasible for "en bloc" resection. Bipolar TURBT was defined as being able to challenge the gold-standard status of monopolar resection due to the reduced complication rates. Plasma-button vaporization was introduced as a promising large bladder tumors' ablation modality. Narrow band imaging (NBI) cystoscopy became an increasingly popular method of enhancing tumor detection., Results: The "en bloc" resection of small size or thin pedicle tumors provides the conditions for avoiding tumoral tissue scattering. Bipolar resection is characterized by decreased perioperative bleeding risks and faster patient recovery. Plasma-button vaporization gained confirmation as an innovative approach, able to dispose large tumor bulks under complete control while minimizing the associated morbidity. NBI cystoscopy is a useful tool in identifying CIS lesions, small papillary tumors or extended margins of large tumor formations. As a cost-free technique, it may be extensively used both during the NMIBC initial diagnostic as well as during follow-up evaluation protocol., Conclusions: Having in mind the various modalities of ameliorating the bladder cancer diagnostic and treatment, NMIBC management should be tailored in accordance with the particularities of each case.

In studies performed until now it was proved that about 80% of bladder tumors discovered as first diagnostic are in a non-infiltrative stage (pTa, pT1, CIS). White light cystoscopy (WLC) is a cornerstone in the diagnosis of bladder diseases in general and especially of tumor pathology. Narrow-band imaging (NBI) cystoscopy represents a complementary endoscopic method based on the principle of visualization in narrow band due to the white light filtration. Thus, is generated an ameliorated contrast between the normal urothelium and tumor hypervascularized tisssue, increasing the rate of detection of urothelial tumors. Comparatively with standard cystoscopy, NBI provides a clearer view of papillary tumors on the one hand, and especially of specific capillary architecture, better defining the edges of plate lession of in situ carcinoma. Studies published until now evidenced a significantly ameliorated tumor detection rate, specific to NBI visualization mode, thus confirming a substantial rate of additional tumors detected exclusively from this method. The specialty literature confirmed a certain category of patients diagnosed with non-invasive bladder cancer only using the NBI endoscopic evaluation. On the other side, this alternative was marked by a reduced specificity compared with conventional cystoscopy, manifested by an increased rate of false-positive outcomes. In conclusion, the changing of the anatomic endoscopic architecture of urinary bladder in tumor pathology was marked by a further quality after the introduction of NBI as additional routinely investigation, without suplementary costs. [ABSTRACT FROM AUTHOR]

Introduction: The present study was aimed to assess in a retrospective manner the impact of narrow band imaging (NBI) cystoscopy concerning the detection of recurrent tumors during the follow-up protocol for previously confirmed non-muscle invasive bladder cancer (NMIBC) patients. Materials and Methods: Between June 2014 and January 2015, a total of 45 known NMIBC cases (based on the initial pathology findings subsequent to standard transurethral resection of bladder tumors - TURBT) were confirmed as presenting tumor recurrence. All cases underwent both standard white light (WLC) and NBI cystoscopy, followed by the classical resection of all WLC detected tumors and NBI guided TURBT for lesions solely observed in NBI vision. Results: In light of the pathological exam, 43 cases were diagnosed with NMIBC recurrence (2 patients had muscle invasive tumors and were excluded from the analysis). The NBI mode was characterized by a higher patients' detection rate when compared to conventional cystoscopy (95.3% versus 83.7%). On a lesions' related basis, the NBI evaluation also displayed an improved diagnostic accuracy by comparison to white light (91.5% versus 79.7%). On the other hand, NBI cystoscopy was marked by an increased rate of false positive results (19.2% versus 13.2%). Conclusions: The use of NBI assessment during the periodical cystoscopic NMIBC follow-up was confirmed to benefit from superior sensitivity leading to more recurrent tumors being identified and resected. [ABSTRACT FROM AUTHOR]