Malik Ayyad
1 
, Omar Ayaad
2* , Hassan Alkhatatbeh
3, Bayan Qaddumi
4, Fadi Sawaqed
5 , Samer Al-Rawashdeh
11 Department of Urology Unit Special Surgery, Faculty of Medicine Mutah University Karak, Jordan
2 Sultan Qaboos Comprehensive Cancer Care and Research Center, University Medical City, Oman
3 Department of General Surgery, Urology and Anaesthesia, Faculty of Medicine, Hashemite University, Zarqa, Jordan
4 Research Center Amman, Jordan
5 Department of Special Surgery, Faculty of Medicine, Mu’tah University, Karak, Jordan
Abstract
Introduction: It is now widely acknowledged within the medical community that flexible cystourethroscopy serves as an effective and indispensable method for monitoring superficial bladder transitional cell carcinoma (TCC).
Objectives: The purpose of this study was to review our previous experience with cystodiathermy performed during flexible cystoscopy for the treatment of recurrent superficial bladder TCC.
Patients and Methods: A longitudinal study was conducted. Patients with a history of TCC in their bladder or upper tract underwent a comprehensive evaluation through flexible cystoscopies over a period of ten months. During the appointment, eligible patients received cystodiathermy under local anesthesia (LA) if deemed appropriate. The duration of treatment and the patient’s tolerance level were carefully documented. However, patients with a history of high-grade disease, recurrent large tumors (>1 centimeter in diameter), or tumors located in areas requiring central deflection were not considered suitable candidates for this particular treatment modality for their cancer recurrences.
Results: Among the 40 documented recurrences, 25 patients (62.5%) had a single recurrence, while ten patients (25%) experienced more than five recurrences. Thirty patients (91%) successfully completed the cystodiathermy procedure without any complications, while two patients (6%) reported experiencing pain during LA cystodiathermy. One patient (3%) had difficulty tolerating the treatment and opted for general anesthesia (GA) instead. Out of the total patient cohort, 22 patients (67%) showed no signs of recurrence. Among those who received cystodiathermy, four patients (12%) required hospital admission.
Conclusion: Cystodiathermy performed under LA is an efficient and well-tolerated alternative to cystodiathermy performed under GA. This approach allows for immediate treatment upon detection, potentially reducing patient anxiety.
Implication for health policy/practice/research/medical education:
• Health policy: The study findings suggest that cystodiathermy performed under local anesthesia (LA) can be an effective and well-tolerated treatment option for recurrent superficial bladder transitional cell carcinoma (TCC).
• Clinical practice: The study demonstrates that cystodiathermy performed under LA is feasible, with a high success rate and low complication rates.
• Research: The study highlights the efficacy and tolerability of cystodiathermy performed under LA.
• Medical education: The findings of this study can be incorporated into medical education curricula to educate future healthcare professionals about the benefits and considerations of cystodiathermy under LA.
• Patient counseling: The study’s results can be used to inform discussions between healthcare providers and patients regarding treatment options for recurrent superficial bladder TCC.
Please cite this paper as: Ayyad M, Ayaad O, Alkhatatbeh H, Qaddumi B, Sawaqed F, Al-Rawashdeh S. Flexible cystodiathermy for the treatment of recurrent superficial bladder transitional cell carcinoma; efficacy, safety, and cost-effectiveness. J Renal Inj Prev. 2025; 14(4): e38386. doi: 10.34172/jrip.2025.38386.