It is not uncommon for urologists to remove tiny tumors in the office with electrofulguration. I've had it done twice. It's done for people with a history of low grade tumors who present with a very small or tiny tumor(s), and the suspicious area is biopsied first. You're right, they don't use anesthetic. In my case it was somewhat painful each time. The multiple "zaps" can get to you, because you wonder how many you're going to have to endure. But it certainly was not as bad for me as other people posting here have perceived it to be. It certainly wasn't something that I'd say "Oh my God, I'll never let them do that to me again." But then, a little Xanax helps a LOT before almost any medical procedure. I found it interesting that they had to "ground" me. I had visions of electrical sparks flying from my body. I did not watch the procedure on a screen, but I did see the doctor give the biopsy specimens to the nurse, and they showed me that.
The first time I had it done, I got the pathology results a week later and they turned out to be benign. It was some sort of tiny, noncancerous growth. So thank God I avoided the whole TUR in the hospital thing. The second time, the pathology reports came back high grade. This was a shock to my urologist and myself, needless to say. Having a 9 year history of low grade grade cancer, it was highly unlikely (3% chance or something like that?) that it would recur as high grade. In that case, of course, I then had a TUR done in the O.R., where it was confirmed to be TaGr3.
Lauren...my one and only tumor in my bladder was so small it was barely visible...it was also extremely invasive and i'm so glad i had a top rate surgeon at Memorial Sloan do the TURB under anesthesia and getting part of the muscle for biopsy. I wouldn't be writing today if it had just been left to the judgement of the local uro to determine whether it was superficial or not.
Ladies, have any of you ever had an endometrial biopsy? It's the same thing, only they don't even use a camera... but they snip a piece of your uterine lining out with anesthetic, too. So I really didn't think this too strange....and I meant it as surprise when I asked if anyone else had it done... I watched him him take the majority of the tumor and then watched the assistant put it in the preservative jar... I didn't watch the whole cauterization, which actually took less than 60 seconds, but he asked me to look when he was finished, and I saw the area flat where there had been a brush little growth earlier..
Surely he isn't the only urologist who does this for small tumors? I recall some here saying that their doctor had cauterized a growth several times without biopsying, meaning they were certain it was not a growth to be worried about. I do prefer the biopsy. I wonder how much more involved a TURB under general anesthetic is, when the tumor is that small?
I had much more painful things done to me for years, in the interest of trying to have a baby!!
My urologist found a shrub-like tumor in my bladder yesterday (it was just over 2 years since my initial TURB and diagnosis of TaG1). He cut most of it out to biopsy, then burned the area. Can I jusy say OUCH? Whatever local anesthetic he used for the cystoscopy didn't hold up to snipping and zapping!!!
Well, I've said this before in previous discussions on this forum. You can anesthetize the urethra with a local anesthetic, and most of us here have enough experience with that to tell you it doesn't make a cystoscopy painless - but there's no way that I'm aware of to anesthetize the inside of the bladder in an awake patient in the urologist's office. I had a biopsy in my previous urologist's office once and I've refused to ever have it done again, but I guess I shouldn't be too surprised since he was never concerned about whether or not he left enough time for the lidocaine gel to work before he plowed ahead. My current urologist says they don't do biopsies in the office.
My biggest concern is not even the patient's discomfort, but rather, whether or not an adequate biopsy can be done for accurate staging. Getting rid of the tumor is not enough
TaG3 + CIS 12/2000. TURB + Mitomycin C (No BCG)
Urethral stricture, urethroplasty 10/2009
CIS 11/2010 treated with BCG. CIS 5/2012 treated with BCG/interferon
T1G3 1/2013. Radical Cystectomy 3/5/2013, No invasive cancer. CIS in right ureter.
Incontinent. AUS implant 2/2014. AUS explant...
You're surprised at the "OUCH" factor!!!....I guess so. If somebody cut a shrub out of me and burnt me to a crisp without anesthesia i'd probably do more than say "OUCH".....personally i think it was highly unethical and i wouldn't go back to him. I'd be seeking another opinion pretty quickly from a major player at a major institution. And really both times i had my TURB's they were done as "outpatient"...It wasn't a big deal. Geez...i'm still cringing........ :o Pat