‘BJUI clinical dilemma’: recurrent high-grade non-muscle-invasive bladder cancer in 2026

Following transurethral resection of bladder tumour (TURBT), high-grade (HG) non-muscle-invasive bladder cancer (NMIBC) is traditionally first treated with BCG. Unfortunately, recurrence and progression have been long-standing problems. There has been a welcome explosion of salvage therapies, which have also resulted in new challenges of optimal treatment selection and sequencing. In this context, recurrence following a single induction or multiple courses of BCG are contemporary clinical dilemmas.

The present ‘BJUI Clinical Dilemma’ presents a structured format to address the common clinical presentation of recurrent HG NMIBC through a case vignette approach. Following the vignette, leading experts will provide brief commentary, explaining rationale for management strategies, novel considerations, and ongoing research. This approach encourages a balanced, expert-driven discussion on alternative strategies, offering readers insights into decision-making processes for common, yet nuanced cases in urological practice.