For treating patients with superficial bladder cancer and a moderate-to-high risk of tumor recurrence or progression, intravesical BCG has been the key development of the last generation. However, BCG has also brought with it a novel set of challenges. An understanding of when, to whom, and how BCG should be given is critical if optimal outcomes are to be achieved. This article the authors reviews the role that BCG has played in the management of bladder cancer over the last several decades and discusses specific approaches to optimize BCG. It focuses on selection and technical strategies.

Perioperative intravesical chemotherapy has a well-established role in the treatment of non-muscle invasive bladder cancer. There are multiple agents that can be used in this fashion with varying properties. Although chemical cystitis is the most common side effect and is usually self-limiting, significant toxicity can occur with intravesical chemotherapy. It is imperative that the urologist is aware of the acute and delayed side effects of intravesical chemotherapy and how to manage potential complications. Both local and systemic toxicities are discussed, as well as strategies to minimize and manage them.

This article provides an overview of intravesical chemotherapy agents used for non-muscle invasive bladder cancer; summarizes the evidence on single-dose perioperative administration, induction therapy, and maintenance therapy; and briefly discusses ongoing research.

This article summarizes the current literature on office-based management of low-grade, noninvasive bladder cancer. Discussion includes differences in recurrence and progression rates between neoplasm grades and stages, role of visual grading for diagnosis, cost advantages of treatment outside the operating room, and a step-by-step description of office-based procedures.

As of 2012, bladder cancer is the fourth most common cancer afflicting men and ninth most common cancer in women. Nearly 80% of all bladder cancer diagnoses are non-muscle invasive at presentation, most of whom will develop recurrent disease within 5 years of initial diagnosis. Urinary tumor markers provide a noninvasive method for both screening and surveillance of bladder cancer. This article reviews the current Food and Drug Administration-approved urinary biomarkers for detection of non-muscle invasive bladder cancer.

The natural history of non-muscle invasive bladder cancer (NMIBC) in individual patients can be unpredictable. Although there are known clinical and molecular factors associated with tumor recurrence and progression, it is challenging to reconcile these data during a typical patient encounter within a busy clinic. The authors discuss the European Organization for Research and Treatment of Cancer's risk tables along with other models for predicting prognosis in patients with NMIBC. The authors also describe their advantages and disadvantages and the barriers to using these risk models in daily clinical practice and provide a future perspective on prognostic models.

This article reviews the impact of stone disease on chronic kidney disease and renal function; evaluating the natural progression of disease as well as the impact of surgical interventions. The impact of stone disease, medical therapy, and surgical therapy for stones on quality of life is discussed.

Kidney stone disease is rising in prevalence in the United States and abroad, and the cost burden of this condition is substantial. Although cost-effectiveness considerations are typically made by policymakers, individual practitioners have become increasingly involved in these discussions, to affect the rising costs of care and to assert control of treatment options. This article reviews existing literature regarding the cost-effectiveness of medical and surgical treatments for stone disease and identifies areas in which additional investigation is needed.