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 embolization followed by transurethral resection to address these challenges.

This retrospective study evaluated patients who underwent preoperative embolization 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.

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). Embolization was performed on the day of surgery in seven cases (63.7%) and 1–4 days before surgery in four cases (36.3%), and complete tumor resection was successfully achieved in all cases. The mean operative time was 78.8 min (range, 33–149 min). No complications related to transurethral resection or embolization, 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 18 months (range, 4–38 months).

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). Embolization was performed on the day of surgery in seven cases (63.7%) and 1–4 days before surgery in four cases (36.3%), and complete tumor resection was successfully achieved in all cases. The mean operative time was 78.8 min (range, 33–149 min). No complications related to transurethral resection or embolization, 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 18 months (range, 4–38 months).