Bladder cancer
Diagnosis & treatment in Vienna

What is bladder cancer?

Bladder cancer usually arises from the lining of the bladder. Men are affected about three times as often as women; smoking is the most important risk factor, followed by occupational exposure to certain chemicals such as dyes, rubber or paints.

Around three quarters of tumours are confined to the lining at diagnosis (non-muscle-invasive). They can be removed endoscopically through the urethra but tend to recur – consistent follow-up is therefore essential. If the tumour grows into the bladder muscle, more extensive treatment is required.

The most important warning sign is painless blood in the urine – even if it happens only once or disappears on its own. Persistent urgency or burning without a proven infection should also be investigated.

Diagnosis of blood in the urine

Blood in the urine always warrants a urological assessment. Alongside urinalysis and cytology, I examine the kidneys and bladder by ultrasound. The decisive look inside the bladder is the cystoscopy – in my practice with an ultra-thin flexible instrument, as an outpatient and within minutes.

If a tumour is confirmed, a CT urogram assesses the upper urinary tract, and surgical removal of the tumour follows, which also provides the tissue for precise staging and grading.

Urinalysis and urine cytology Ultrasound of kidneys and bladder Flexible cystoscopy CT urography Transurethral or en-bloc resection with histology
More about cystoscopy

Treatment of bladder cancer

01.
En-bloc laser resection (ERBT)

I remove superficial tumours with the laser in one piece, including the underlying muscle layer. This allows more precise assessment by the pathologist and a more complete removal than classic piecemeal resection.

More about laser resection
02.
Intravesical therapy (BCG or chemotherapy)

To prevent recurrence, a drug is instilled directly into the bladder depending on your risk profile – once after surgery, or as a course of BCG over several months. I set the plan with you according to the current EAU guidelines.

03.
Radical cystectomy

For muscle-invasive cancer, removal of the bladder with urinary diversion (neobladder or stoma) is the standard treatment, usually after preparatory chemotherapy. In selected cases a bladder-preserving combination of resection, chemotherapy and radiotherapy is an option.

04.
Follow-up

After any bladder cancer treatment, regular cystoscopies are necessary – every three months at first. I provide follow-up in my practice so that recurrences are caught early and small.

Frequently asked questions

Blood in the urine – do I need to see a doctor right away?

Yes, promptly – even if it happened only once and there is no pain. The cause is usually harmless, but bladder cancer must be excluded, and when found early it is very treatable.

Is cystoscopy painful?

With a flexible, ultra-thin instrument and lubricant gel, the examination is well tolerated by most patients and takes only a few minutes.

How high is the risk of recurrence?

Non-muscle-invasive tumours recur in about half of patients but rarely progress. Intravesical therapy and consistent follow-up reduce this risk considerably.

Why a second opinion for bladder cancer?

The decision between bladder preservation and cystectomy, or for BCG therapy, has far-reaching consequences. As a member of an EAU guidelines panel for non-muscle-invasive bladder cancer, I help you put your results into perspective.

About second opinions
Book a consultation