This Article Full Text (PDF) Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Riches, E. W. Search for Related Content PubMed Articles by Riches, E. W.

II. Some Further Aspects of Treatment

Middlesex Hospital

This excerpt was created in the absence of an abstract.

Mr. Jacobs has given an excellent survey of the methods of treatment available in this disease and the indications for their use. I find myself in very close agreement with much of what he has said; if, therefore, I appear to indulge in needless repetition I trust you will regard it more as necessary reiteration.

Both the treatment and prognosis depend most upon the pathological type of growth and its situation in the bladder. Other factors which have an obvious bearing are the age and general condition of the patient, and the size and multiplicity of the lesions.

Bladder tumours show wide variations in their malignancy; at one end of the range is the simple papilloma, which can be cured by cysto-diathermy, and at the other the highly malignant ulcerative carcinoma. Intermediate between these are the papilloma of uncertain malignancy and the papillary and nodular carcinomata. Cystoscopic biopsy will occasionally help in the differentiation, but its use is limited by the need to remove part of the tumour base. The cystoscopic appearance forms the most reliable pre-operative guide.

A single tumour in the upper or movable part of the bladder lends itself readily to partial cystectomy, and I am not convinced that tumours in this position are any more liable to recur than those on the fixed base, provided that the margin of tissue removed is adequate both in width and depth.