Challenging the EAU Guidelines on Non-Muscle-Invasive Bladder Cancer (NMIBC): Single Instillation of Chemotherapy After Transurethral Resection of NMIBC and Chemotherapy Versus Bacillus Calmette-Guérin in Treatment of Intermediate-Risk Tumours

A complete TUR of the bladder tumour plus immediate, postoperative, chemotherapeutic instillation is recommended for all patients with primary, solitary NMIBC, except in those with bladder wall perforation. For these low-risk tumours, no further therapy is required. For intermediate-risk disease, intravesical induction BCG plus maintenance should be considered the first choice, while intravesical chemotherapy should be considered for intermediate-risk and low-risk tumours (single, recurrent, low-grade NMIBC). In these patients, one immediate single instillation of chemotherapy should not be administered after TUR.