Preoperative selective arterial embolization followed by transurethral resection of bladder tumor for large bladder tumors - Early clinical experiences

Sep 22, 2026

Transurethral resection of bladder tumor (TURBT) for large non–muscle-invasive tumors (≥5 cm) is technically demanding and increases risks of transfusion, bladder perforation, and incomplete resection. A retrospective study evaluated patients treated at two tertiary hospitals from 2021–2024 with preoperative selective arterial embolization (SAE) immediately before or shortly before TURBT. Among 11 patients, complete resection was achieved in all cases with no SAE/TURBT-related complications, while recurrence occurred in 54.5% and no progression was observed over a median 24-month follow-up.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Introduction

Background and rationale

Materials and Methods

Study design and patient selection

Results

Resection outcomes and complications

Conclusions

Original Article-Urological Oncology Investig Clin Urol 2026;67:162-169. [https://doi.org/10.4111/icu.20250352](https://doi.org/10.4111/icu.20250352)[ ](https://doi.org/10.4111/icu.20250352)[pISSN 2466-0493](pISSN 2466-0493) • eISSN 2466-054X Preoperative selective arterial embolization followed by transurethral resection of bladder tumor for large bladder tumors: Early clinical experiences Sungun Bang1, Seung-Moon Joo2, Do Kyung Kim1, Jong Kyou Kwon1, Seokhwan Bang3, Dongho Shin3, Jinhyung Jeon4, Sung-Hoo Hong3, Kang Su Cho1,5 1Department of Urology, Prostate Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 2Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 3Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, 4Department of Urology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, 5Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul, Korea Purpose: Transurethral resection of bladder tumor for large tumors (≥5 cm) is challenging, even for experienced surgeons, due to increased risks of transfusion, bladder perforation, and incomplete resection. We developed a sequential strategy involving preoperative selective arterial embolization (SAE) followed by transurethral resection to address these challenges. Materials and Methods: This retrospective study evaluated patients who underwent preoperative SAE followed by transurethral resection for non–muscle-invasive bladder cancer at two tertiary hospitals between 2021 and 2024. Potential candidates were patients newly diagnosed with large bladder tumors (longest diameter of the main mass ≥5 cm) and suspected non–muscle-invasive bladder cancer on preoperative studies. Results: Eleven patients (mean age, 73.2 years) were included in this study. The mean tumor size was 5.78 cm (range, 5.0–8.0 cm) . SAE was performed on the day of surgery in seven cases (63.6%) and 1–4 days before surgery in four cases (36.4%), and complete tumor resection was successfully achieved in all cases. The mean operative time was 78.8 minutes (range, 33–149 minutes) . No complications related to transurethral resection or SAE, including the need for transfusion or reoperation, were observed. Pathology results revealed Ta in six cases and T1 in five cases. Disease recurrence occurred in six patients (54.5%); however, none demonstrated disease progression during a median follow-up of 24 months (range, 6–44 months) . Conclusions: Our early experiences demonstrated that preoperative SAE followed by transurethral resection for large non-muscle-invasive bladder cancers may be a feasible approach for achieving complete resection without complications. Keywords: Embolization, therapeutic; Transurethral resection of bladder; Tumor burden; Urinary bladder neoplasms This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([http://creativecommons.org/licenses/by-nc/4.0](http://creativecommons.org/licenses/by-nc/4.0)) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Received: July 29, 2025 • Revised: September 23, 2025 • Accepted: November 14, 2025 • Published online: January 22, 2026 Corresponding Author: Kang Su Cho [https://orcid.org/0000-0002-3500-8833](https://orcid.org/0000-0002-3500-8833) Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea TEL: +82-2-2019-3470, E-mail: [kscho99@yuhs.ac](kscho99@yuhs.ac) Sung-Hoo Hong [https://orcid.org/0000-0002-1952-4010](https://orcid.org/0000-0002-1952-4010) Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero

FAQs

What problem does the study address in treating large bladder tumors?

It addresses the technical difficulty of performing TURBT for large non–muscle-invasive tumors (≥5 cm), which increases risks such as transfusion, bladder perforation, and incomplete resection.

How were patients selected for the SAE followed by TURBT strategy?

Patients were newly diagnosed with large bladder tumors (longest diameter of the main mass ≥5 cm) and suspected non–muscle-invasive bladder cancer on preoperative studies.

What were the main outcomes regarding safety and complete resection?

Complete tumor resection was achieved in all included patients, and no complications related to TURBT or SAE (including transfusion or reoperation) were observed.

Sep 22, 2026

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