Andy,
Thanks. UM may (should) want to reTURBT to be sure that it is staged correctly. If the pathology is confirmed they would most likely recommend BCG or a combination of BCG with something else (e.g Interferon).
If the BCG is effective, that would probably be the route to go for now. Of course, if there is a recurrence then you pretty much know the direction things are going and my personal opinion would be to make the call for RC at that time.
Hopefully, the BCG would be effective though and you never have to make that call.
If UM does not suggest reTURBT, I'd ask them why not? My approach is to be very aggressive about treatment. Others, including doctors, try to keep the bladder for as long as possible. That's fine as long as it isn't just giving the cancer more opportunity to sneak out of the bladder.
In my case, I'm pretty sure the cancer had just barely gotten through the inner layer to the muscle when I got my bladder out. 41 lymph nodes went with it and all were clear so I'm hoping that I got mine out in time.
I can tell you that if you go the BCG route with the regular cysto schedule (every 3 months to start) that cytologies are very important. Even though they couldn't see anything on my cystos, it had come back. I had blood in the urine though so I knew something was wrong and I was right. In my case it was CIS which can be invisible.
Mike