Deep resection for correct histopathological analysis in TUR-B can be challenging for the surgeon with a low to mid-experience level. This leads to inadequate analysis, possibly postponing radical cystectomy.
How do you do it? Do you only rely on what you see?
Around 90% of time I am sure of deep muscle which I usually take separately.
Apart from visual confirmation of muscle fiber in TURBT chips as well as at the resection site , i usually take deep muscle in the partial filled bladder that will increase the thickness of bladder wall and decrease the chance of perforation. Along with this ,after removal i palpate the chips between thump and index finger. Chips with muscle fibers are often firmer than chips with tumor tissue alone . these are few tricks to increase yield of muscle fibers in deep muscle biopsy chips.
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