Can Stage 2 be diagnosed at first TURBT?

Sue,

To add what has been posted, my experience is almost exactly the same as youre. 1st TURB was inconclusive, some low grade and some grade 2 that might have even been grade 3. My URO is conservative and thankful that he is! I am around almost 8 years later. Sounds like you are in good hands.

Sue, the answer is "it depends." IF muscle tissue was included in the first biopsy, it is certainly possible that a complete diagnosis could result the first time. Some urologists never do a second (I wouldn't want them to be my urologist!)
Sometimes there appears to be no need for a second. I suspect that in the case of a very small papillary tumor with no other areas "suspicious" it wouldn't be necessary.

Clear as mud!!!

Sara Anne

Your uro is "right on" as far as diagnostic tests are concerned. Studies have shown that too often the results of an initial TURB need to be refined by a second and this is not done often enough. The first time, the uro is sort of flying blind...he thinks he knows from what he has seen in cystoscopy where the problem areas are so that is where he takes samples. Sometimes he doesn't get enough tissue to include muscle. He is a bit cautious...doesn't want to perforate the bladder or do any damage. If he decides that a second TURB is necessary, he has a better idea of where to take samples and how deep to go. And yes, a first TURB can diagnose any stage....it just depends what the samples show.

The results from my first TURB showed papillary low grade, and "areas of undefined irritation." When my uro did a second, giving special attention to those areas, the results showed CIS which is high grade and requires immediate attention. So glad that my uro was enough on the ball to do the second.

Sounds as if you have a good urologist, and the BCG is indicated also.

Sara Anne