Urology · NEET PG Preparation Surgery
A 45-year-old male presents with painless gross total hematuria. Cystoscopy reveals a 3 cm papillary growth on the lateral wall of the urinary bladde…
Practice question from Urology (NEET PG Preparation Surgery), with the correct answer and a step-by-step solution.
medium · MCQ · Q-488290
A 45-year-old male presents with painless gross total hematuria. Cystoscopy reveals a 3 cm papillary growth on the lateral wall of the urinary bladder. Transurethral resection of bladder tumor (TURBT) is performed, and histopathology shows a high-grade urothelial carcinoma invading the lamina propria but sparing the muscularis propria (T1). What is the most appropriate next step in management?
- A.Immediate radical cystectomy with bilateral pelvic lymph node dissection
- B.Intravesical Bacillus Calmette-Guérin (BCG) immunotherapyCorrect answer
- C.Systemic platinum-based combination chemotherapy alone
- D.Active surveillance with cystoscopy every 3 months
Solution
High-grade T1 urothelial carcinoma of the bladder carries a significant risk of progression and recurrence. After complete TURBT, adjuvant intravesical Bacillus Calmette-Guérin (BCG) immunotherapy is the standard of care to reduce recurrence and progression rates. Radical cystectomy is reserved for BCG failure or deeper muscle invasion (T2 or greater).
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