Document Detail


Routine surveillance cystoscopy for patients with augmentation and substitution cystoplasty for benign urological conditions: is it necessary?
MedLine Citation:
PMID:  19239457     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate screening cystoscopy as the long-term follow up in patients with an enterocystoplasty for > or =10 years. PATIENTS AND METHODS: We performed a prospective analysis of 92 consecutive patients who attended our endoscopy suite for regular check cystoscopy as per standard follow-up. This is performed for all patients with cystoplasty performed at our institute after 10 years. The data were recorded on patient demographics, original diagnosis and type of cystoplasty. In all, 53 of these patients consented to undergo bladder biopsies at the same time. RESULTS: The median (range) follow-up was 15 (10-33) years. No cancer was identified with either surveillance cystoscopy or on routine biopsies. Chronic inflammation was identified in 25 biopsies (27%). Villous atrophy was present in 12 (55%) ileal patch and three (12.5%) colonic patch biopsies. During this study, the first and only case of malignancy in a cystoplasty at our institution was diagnosed in a symptomatic patient. She had intermittent haematuria and recurrent urinary tract infections (UTIs). She previously had a normal surveillance cystoscopy. CONCLUSIONS: We feel that it is not necessary to perform yearly check cystoscopies in patients with augmented bladders at least in the first 15 years, as cancer has not yet been detected with surveillance cystoscopy in this patient group. However, if the patient develops haematuria or other worrisome symptoms including suprapubic pain and recurrent unexplained UTIs a full evaluation, including cystoscopy and computerized tomography should be undertaken.
Authors:
Rizwan Hamid; Tamsin J Greenwell; Janine M Nethercliffe; Alexander Freeman; Suzie N Venn; Christopher R J Woodhouse
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2009-02-23
Journal Detail:
Title:  BJU international     Volume:  104     ISSN:  1464-410X     ISO Abbreviation:  BJU Int.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-20     Completed Date:  2009-09-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  392-5     Citation Subset:  IM    
Affiliation:
Institute of Urology and University College London Hospital, London, UK. hamid_rizwan@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cystitis / etiology
Cystoscopy / utilization*
Epidemiologic Methods
Female
Hematuria / etiology
Humans
Long-Term Care
Male
Middle Aged
Postoperative Complications / diagnosis*,  etiology
Unnecessary Procedures / utilization*
Urinary Bladder Diseases / complications,  surgery*
Urinary Bladder Neoplasms / diagnosis*,  etiology
Urinary Diversion
Urinary Reservoirs, Continent
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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