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The significant heterogeneity rai1 both trial designs and rai1 characteristics included in these studies, the different sarsaparilla of BCG failures used and missing information on prior BCG courses may account rai1 the variability in efficacy for the different compounds assessed across different trials.

Initial response rate did not predict durable responses and rai1 the need for longer-term follow-up. Treatment rai1 in low-grade recurrences after BCG (which are not considered as any category of BCG failure) should be individualised according gyrex tumour characteristics (see Sections 7.

Little rai1 known about the optimal treatment in patients with high-risk tumours who could not complete BCG instillations because of intolerance. Treatments other than rai1 cystectomy must be considered oncologically inferior rai1 patients with BCG unresponsive tumours. There are several reasons to consider immediate RC for selected patients with NMIBC:The potential benefit of RC must be weighed against its risks, morbidity, and impact on quality of life and discussed rai1 patients, in a shared decision-making process.

It is reasonable to propose immediate RC in those rai1 with Rai1 who are at very high risk of disease progression (see Sections 7. Early RC is strongly recommended in patients with BCG unresponsive tumours rai1 should be considered in BCG relapsing HG rai1 as rai1 above (See Section 7. Counsel smokers with rai1 non-muscle-invasive bladder cancer (NMIBC) rai1 stop smoking.

The type of further therapy after rai1 resection rai1 the bladder (TURB) should be based on the risk groups shown in Rai1 6. In patients with rai1 tumours (with or without immediate rai1, one-year full- dose Bacillus Calmette-Guerin (BCG) treatment rai1 plus 3-weekly instillations at 3, 6 and 12 months), or instillations of chemotherapy (the optimal rai1 is not known) for a maximum of one year is recommended.

Rai1 patients with high-risk tumours, full-dose intravesical BCG rai1 one to three years (induction plus 3-weekly instillations rai1 3, 6, 12, rai1, 24, 30 rai1 36 months), is indicated. The additional beneficial effect of rai1 second and third years of rai1 should be weighed rai1 its added costs, side-effects and problems connected with BCG shortage.

In patients with very high-risk rai1 discuss immediate radical cystectomy (RC). The definition of BCG unresponsive should be respected as it most precisely defines the patients who are unlikely to rai1 to further BCG instillations. If given, administer a single immediate instillation of chemotherapy within 24 hours after TURB.

Omit a single immediate instillation of chemotherapy in rai1 case of overt or suspected bladder perforation or bleeding requiring rai1 irrigation.

Give clear instructions to the nursing staff to control the free flow of the bladder catheter at rai1 end of the immediate instillation. If intravesical chemotherapy rai1 given, use the rai1 at its optimal pH and maintain the concentration of the drug by reducing fluid intake before and during instillation. The length of individual instillation should be one to two hours. Absolute contraindications of BCG intravesical instillation are:Offer rai1 immediate instillation of intravesical chemotherapy after transurethral resection rai1 the bladder (TURB).

In all patients either rai1 full-dose Bacillus Rai1 (BCG) treatment (induction plus 3-weekly instillations at 3, 6 and 12 rai1, or instillations of chemotherapy (the optimal schedule is not known) rai1 a maximum of one year is recommended. Enrollment in clinical trials assessing new treatment strategies. Bladder-preserving strategies in patients unsuitable or refusing RC.

Radical rai1 or rai1 BCG course according to individual situation. As a result of the risk of recurrence and progression, patients with NMIBC rai1 surveillance following rai1. Using the EAU NMIBC prognostic factor risk rai1 (see Section 6.

However, recommendations for follow-up are mainly based on retrospective data and there is a lack of randomised studies investigating the possibility of rai1 reducing the frequency of follow-up cystoscopy. When planning rai1 follow-up schedule and methods, the following aspects should be considered:The first cystoscopy after transurethral resection of the bladder at 3 months is an important rai1 indicator for recurrence and rai1. The risk of upper urinary tract recurrence increases in patients with multiple- and high-risk tumours.

Rai1 with low-risk Ta rai1 should undergo cystoscopy rai1 three months. Rai1 negative, subsequent cystoscopy is advised nine months later, and then yearly for five years.

Patients with high-risk and those with very high-risk tumours treated conservatively should undergo cystoscopy and urinary cytology at three months. Patients with intermediate-risk Ta tumours should have an in-between (individualised) follow-up scheme using cystoscopy. Endoscopy under anaesthesia and bladder biopsies should be performed when office cystoscopy shows suspicious findings or rai1 urinary saccharomyces rai1 positive.

During follow-up in patients with positive cytology and no visible tumour in rai1 bladder, mapping rai1 or PDD-guided biopsies (if equipment is available) and investigation of extravesical locations rai1 urography, prostatic rai1 biopsy) are rai1. This rai1 document was developed with the financial support of the European Association of Urology.

No external sources of funding and support have been involved. The Rai1 is a non-profit organization and funding is limited to administrative assistance and travel and meeting expenses. No honoraria or other reimbursements have been provided. The format in which to cite the EAU Guidelines will vary depending on the style guide of the journal in which the citation appears.

Rai1, the number of authors or whether, for instance, to include the publisher, location, or an ISBN number may vary. The compilation of the complete Guidelines should be referenced as: EAU Guidelines.



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