UROLOGY · CONDITIONS
Urothelial / Transitional Cell Carcinoma
Cancer arising from the urothelial lining of the bladder, ureter, or renal pelvis — requiring stage-specific management from endoscopic resection to radical surgery.
ABOUT THIS CONDITION
What is Urothelial / Transitional Cell Carcinoma?
Urothelial carcinoma (formerly transitional cell carcinoma) can arise anywhere along the urothelium — most commonly in the bladder, but also in the ureters and renal pelvis (upper tract TCC). Painless haematuria is the hallmark symptom. Management is risk-stratified: TURBT and BCG for bladder NMIBC, radical cystectomy for muscle-invasive disease, and nephroureterectomy for upper tract TCC. Dr. Vipin provides comprehensive urothelial cancer care — from diagnostic TURBT and surveillance cystoscopy to radical cystectomy with urinary diversion — coordinated with oncology for a multidisciplinary approach.
SIGNS TO WATCH
Common Symptoms
Symptoms that need attention
WHY IT HAPPENS
Causes & Risk Factors
- Cigarette smoking — greatest single risk factor
- Occupational aromatic amine exposure (dyes, rubber, paint)
- Chronic bladder irritation — stones, catheters, infection
- Cyclophosphamide chemotherapy exposure
- Balkan nephropathy (aristolochic acid) for upper tract TCC
- Family history or Lynch syndrome
CLINICAL DETAILS
KeyFacts
Any episode of painless haematuria in an adult over 35 requires urgent cystoscopic investigation.
Simultaneously diagnoses and treats non-muscle-invasive disease in a single endoscopic procedure.
Gold standard intravesical immunotherapy for high-risk NMIBC — 6-week induction plus maintenance.
Nephro-ureterectomy for UTUC — laparoscopic approach with bladder cuff excision as standard.
Lifelong cystoscopic surveillance mandatory — bladder TCC recurs in up to 70% within 5 years.
Stopping smoking reduces recurrence risk and improves survival after treatment.
HOW WE TREAT IT
Treatment Approach
TURBT (Transurethral Resection of Bladder Tumour)
Transurethral resection of the bladder tumour — simultaneously diagnoses and treats non-muscle-invasive urothelial carcinoma, providing histological stage and grade in a single endoscopic procedure.
- 1
Cystoscopy & TURBT
Flexible cystoscopy identifies the tumour. TURBT under anaesthesia resects the tumour completely — providing staging pathology and primary treatment.
- 2
Risk Stratification
Pathology determines stage and grade. Low, intermediate, or high-risk stratification dictates the need for intravesical therapy and surveillance frequency.
- 3
Intravesical Therapy
BCG induction (6 instillations) and maintenance for high-risk NMIBC. Single MMC instillation immediately after TURBT for low-risk disease.
- 4
Radical Surgery if Needed
Muscle-invasive or BCG-unresponsive disease treated with radical cystectomy + urinary diversion. UTUC treated with nephroureterectomy.
AVAILABLE TREATMENTS
Treatment Options
TURBT (Transurethral Resection of Bladder Tumour)
Endoscopic resection of urothelial bladder tumours — the cornerstone of diagnosis and treatment of non-muscle-invasive TCC.
Radical Cystectomy — Open / Laparoscopic / Robotic
Complete bladder removal with pelvic lymphadenectomy for muscle-invasive urothelial carcinoma — curative intent surgery.
Nephro-Ureterectomy — Laparoscopic / Open
En bloc removal of kidney, ureter, and bladder cuff for upper tract TCC of the renal pelvis or ureter.
Pelvic Lymph Node Dissection (PLND)
Extended pelvic lymphadenectomy at cystectomy — provides staging and potential therapeutic benefit in node-positive disease.
COMMON QUESTIONS
Frequently Asked
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