No intra-operative or postoperative com- plications were recorded. All patients were discharged on the same day. Post procedure questioners confirmed the pro- cedure was tolerated well by patients and was associated with low anxiety levels. In our second arm (n=30) the average length of hospital stay for a general anaes- thetic cystodiathermy is 2.56 days for. Mean operating time was 34 minutes (30-76 minutes). The average cost of per- forming cystodiathermy in the main the- atre per person is £1575. While the aver- age cost of having cystodiathermy in the Day Stay Unit per person is £1075. Conclusion: Office cystodiathermy for small, low-grade papillary recurrence is safe and efficacious in well tolerated in patients. This change in practice can po- tentially improve patient quality of life and have a major economic impact on health care. Additionally, patients deemed high anaesthetic risk patient would bene- fit from having the procedure performed under flexible cystoscopy guidance and local anaesthetic control. MP-15.02 Efficacy of managing small recurrent bladder tumours by diathermy using the CYF-4 Olympus flexible cystoscope in the day surgery unit Chandrasekar P, Krishnamoorthy G, Walkay G, Calleary J, Samman R, Virdi J, Potluri B Princess Alexandra Hospital NHS Trust, Harlow, UK Introduction: Traditionally small bladder tumour recurrences have been treated by cystodiathermy requiring regional or gen- eral anaesthesia and in many cases an overnight stay in hospital. We conducted a feasibility trial to assess the diathermy destruction and outcome of these recur- rent superficial bladder tumours using the CYF- 4 Olympus flexible cystoscope in the day surgery unit. Methods: From June 2002 to June 2005, 65 patients underwent flexible cystoscopy and diathermy using 2% lignocaine gel as topical urethral anaesthesia. The age of the patients ranged from 34 to 94 years (mean=71.6). Prior to this check cystos- copy all the patients had undergone trans- urethral resection of bladder tumour and their tumours were staged and graded. During cystoscopy the urethra and blad- der were examined for recurrent tumours (number, location and size). Patients with small recurrent tumours up to 5 in num- ber were treated with diathermy. Patients were asked to grade the pain (mild, mod- erate, severe) and willingness to undergo the same procedure again. All the patients underwent check flexible cystoscopy 3 months after the diathermy to look for recurrences. Results: 65 patients (49 males and 16 females) had 111 cystodiathermy sessions. A total of 176 bladder tumours were dia- thermised during these sessions. The num- ber of tumours varied from 1 to 5. The size of the tumours ranged between 2mm to 20mm. Among the patients who had cystodiathermy, 2 patients (1.8%) experi- enced moderate pain and others only mild pain. All patients (99%) except one were willing to undergo the same procedure again. The follow up cystoscopy at 3 months showed no recurrences in 161 sites (91.5%), recurrences at or close to the previous site in 3(1.7%) and recur- rence at different site in 12 (6.8%). Conclusions: Cystodiathermy of small recurrent bladder tumours under local anaesthesia using the CYF-4 Olympus flex- ible cystoscope is feasible as a day case procedure. Patient tolerance for the pro- cedure was good. Hospital admissions and complications associated with general or regional anaesthesia has been avoided. The local recurrence rate was only 8.5% ands these recurrences can also be treated as a day case procedure again. MP-15.03 Initial experience with intravesical gemcitabine treatment of urinary bladder superficial transitional cell carcinoma Mullerad M, Kravtzov A, Meyer G, Kastin A, Gross M, Biton K, Elias I, Boaz M, Ofer N Urology Department, Bnai Zion Medical Center, Haifa, Israel Introduction: Our aim was to evaluate the feasibility, tolerability and efficacy of intravesical Gemcitabine (IVG) given to superficial urinary bladder transitional cell carcinoma (SUBTCC) patients. Methods: Twenty four patients with SUB- TCC (average age 66 years, 19 men, and 6 women) received 6 weekly IVG treat- ments (Gemcitabine 2gr/50cc). IVG was given as a first line treatment in 18 SUB- TCC patients with either 3 or more le- sions or a single TaG1 tumor of above 3 cm in diameter, or any TaG2-3 or T1G1-2. In six patients Gemcitabine was given as a second line after a failure of previous treatment (Mitomycin-6, BCG-5, KLH-4). Tolerability was evaluated in all 24 pa- tients, over all efficacy was evaluated in 21 patients. Kaplan Meier curves were used to establish 2 years freedom from recurrence. Results: Twenty two patients have com- pleted the planed treatment. Two patients (one developed recurrent urinary tract infection (UTI) and another epididymitis) did not complete the treatment. Over all recurrent UTI was seen in one patient while epididymitis in two. Three patients could not hold the Gemcitabine for more than 20 minutes; two of them were im- proved with the help of anticholinergic treatment. One patient with known pros- tatic enlargement developed acute urinary retention. Of all 21 fully treated patients mean follow up time was 17 months (me- dian 13). Six developed recurrence with- out progression. Kaplan Meier curve found 68% freedom from disease at two years time. Conclusion: Intravesical Gemcitabine treatment is well tolerated. Preliminary results demonstrate acceptable recurrence rate at two years however further studies are needed to establish Gemcitabine treat- ment efficacy. MP-15.04 Hybrid SPECT-CT, an additional technique for sentinel node detection of patients with invasive bladder cancer Sherif A 1 , Garske U 2 , de La Torre M 3 , Thorn M 4 1 Department of Urology, Karolinska Uni- versity Hospital, Sweden ,2 Department of Medical Sciences / Nuclear Medicine, Uppsala University Hospital, Sweden; 3 Department of Pathology and Cytology, Uppsala University Hospital, Sweden, 4 Department of Surgery, Karolinska In- stitute, South Stockholm General Hospi- tal, Stockholm, Sweden Introduction: To explore the feasibility of performing lymphoscintigraphy com- bined with computerized tomography for preoperative detection of sentinel lymph nodes in patients with invasive bladder cancer. Methods: Six consecutive patients planned for radical cystectomy underwent lymphoscintigraphy after transurethral injection of Albures -Technetium 99m in the detrusor muscle peritumorally both with planar imaging and with SPECT/CT. Computerized tomography for anatomic fusion was performed directly after the SPECT/CT and both investigations were combined to a fused image. Radical cys- tectomy started with extended lymphade- nectomy and intraoperative detection of sentinel nodes with both Geiger-probe and dye marker. The conventional planar lymphoscintigraphies and the fused SPECT/CT were compared with each MODERATED POSTER SESSIONS 148 UROLOGY 68 (Supplement 5A), November 2006