The vigorous irrigation's causes some of the cells lining the bladder to fall off much the same way as shaking apples off an apple tree. This specimen is optimal for DNA ploidy analysis. The tumor is removed through another telescopic instrument. Biopsies of normal-appearing bladder lining are performed to check for microscopic cancer that would otherwise be missed by the surgeon's eye. Although superficial bladder tumors tend to recur frequently, most of recurrent tumors stay in the superficial areas.
Invasive tumors have a higher risk to metastasize.
TNM system for staging bladder cancer.