Audit of safety, efficacy, and cost-effectiveness of local anaesthetic cystodiathermy

• Published in: Annals of the Royal College of Surgeons of England 2010-11, Vol.92 (8), p.706-709
• Main Authors: Davenport, Kim, Keeley, Jr, Francis X, Timoney, Anthony G
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anesthesia; Anesthesia, Local; Bladder; Carcinoma, Transitional Cell - pathology; Carcinoma, Transitional Cell - surgery; Cost-Benefit Analysis; Electrocoagulation - adverse effects; Electrocoagulation - economics; Electrocoagulation - methods; Female; Follow-Up Studies; Histology; Hospitals; Humans; Lasers; Local anesthesia; Male; Medical Audit; Middle Aged; Neoplasm Recurrence, Local - surgery; Patient satisfaction; Treatment Outcome; Tumors; Urinary Bladder Neoplasms - pathology; Urinary Bladder Neoplasms - surgery; Urological Surgery
• ISSN: 0035-8843; 1478-7083
• DOI: 10.1308/003588410X12699663904835

The aim of this study was to audit our experience of cystodiathermy under local anaesthetic (LA) at the time of flexible cystoscopy for recurrent superficial bladder transitional cell carcinoma (TCC). A total of 264 flexible cystoscopies were performed on patients with a past history of TCC. The number and site of recurrences were recorded and selected patients were offered cystodiathermy. Patient tolerability was noted. At follow-up, any recurrence was recorded. Eighty patients (30%) had 91 procedures showing one or more recurrences. Fifty-one of the 80 patients (64%) were treated with cystodiathermy under LA. All completed treatment. Forty-five (88%) tolerated the procedure well. Forty-seven (92%) treatments were completed within 5 min. At a median follow-up of 15 weeks, 30 (59%) treated patients had no recurrence and three (6%) had recurrence at the site of treatment. LA cystodiathermy is an effective and well-tolerated alternative to general anaesthetic cystodiathermy that enables treatment at the time of detection and may, thereby, reduce patient anxiety.