• Ilker Tinay, Sumer Baltaci, Cetin Demirdag, Bulent Akdogan, Ugur Yucetas, Muhammed Fatih Simsekoglu, HaberalHakan BahadırHBhttps://orcid.org/0000-0001-9774-2040Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey., Murat Bozlu, Volkan Izol, Guven Aslan, Nural Bekiroğlu, and Bladder Cancer Study Group of Urooncology Association, Turkey.
• Department of Urology, Marmara University School of Medicine, Istanbul, Turkey.
• Int. J. Clin. Pract. 2021 Apr 1; 75 (4): e13924.

PurposeTo evaluate the effect of second transurethral resection (TUR) on oncological outcomes, according to the presence or absence of detrusor muscle in the initial TUR of patients with pTa Grade 3/high grade (G3/HG) tumours, who received at least 1 year of maintenance Bacillus Calmette-Guerin (BCG) therapy.Patients And MethodsIn this retrospective study, we evaluated the effect of second TUR on oncological outcomes of 93 patients with pTa G3/HG tumours, according to the presence or absence of muscle in the initial TUR. All patients received maintenance BCG therapy according to the SWOG protocol.ResultsMedian follow-up was 36 months. If muscle is present in the initial TUR, a second TUR significantly increased median time to first recurrence, compared to those without a second TUR (77.6 vs 36.9 mos, P = .0086). If muscle is missing in the initial TUR, a second TUR significantly decreased recurrence rate (20% vs 66.7%, P = .002), increased median time to first recurrence (78.9 vs 42.7 mos, P = .0001) and median time to progression (22 vs 7 mos, P = .05), compared to those without a second TUR.ConclusionIn patients with pTa G3/HG tumours, if the muscle is missing in the initial TUR, a second TUR should be performed in order to attain lower recurrence rates and longer median time to recurrence and progression. If the muscle is present in the initial TUR, a second TUR will only increase median time to first recurrence.© 2020 John Wiley & Sons Ltd.

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