Well, I guess that would be part of my point. Since understaging is a big concern, and I don't believe it's a given that anything under G3 is always superficial, just how good is that in office biopsy to be worth the pain? Can an in office biopsy adequately evaluate CIS?
Now my experience may be different from others. We all tolerate different things differently. When I had my one in office biopsy which I refused to repeat, I had no tumors - just erythema. And the specimen was inadequate - probably because one can't go too deep without anesthesia. Maybe I just have a sensitive bladder. I always have urinary symptoms after a cystoscopy and take, on average, 1½ weeks to fully recover. But since each cystoscopy I have does require a urethral dilation, which I do willingly although not happily wide awake without sedatives, I don't think I'm a wimp. I still say I'll pass on in office biopsies.
-Warren
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 5/2014
Pediatrician