Nickan Research Institute Journal of Renal Injury Prevention 2345-2781 14 4 2025 12 01 Flexible cystodiathermy for the treatment of recurrent superficial bladder transitional cell carcinoma; efficacy, safety, and cost-effectiveness e38386 e38386 10.34172/jrip.2025.38386 EN Malik Ayyad https://orcid.org/0000-0002-8962-3591 Omar Ayaad https://orcid.org/0000-0003-1521-117X Hassan Alkhatatbeh Bayan Qaddumi Fadi Sawaqed https://orcid.org/0000-0002-5743-880X Samer Al-Rawashdeh Journal Article 10.34172/jrip.2025.38386 2024 08 25 2025 01 10 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.