Alternatives to the cystoscopic control of bladder neoplasms
Páez Borda, A.; Luján Galán, M.; Martín Osés, E.; Berenguer Sánchez, A.
Archivos Espanoles de Urologia 50(10): 1079-1083
1997
ISSN/ISBN: 0004-0614 PMID: 9494196 Document Number: 472451
Cystoscopy is the most sensitive technique for the detection of bladder tumor recurrence, but is the least accepted by the patient. In our Service, 25% of cystoscopies are poorly tolerated. Our experience with alternatives to cystoscopy is described. Using cystoscopy as the gold standard, we analyzed the diagnostic yield of cytology, vesicorenal US and the combination of vesicorenal US and cytology. The techniques were compared for sensitivity vs 1-specificity. The sensitivity of the alternative techniques was limited. At best it was 0.81 when US and cytology were used in combination. The specificity was low and the incidence of false negatives was 7.3%. Similarly, the diagnostic yield was better when US and cytology were used in combination (sensitivity vs 1-specificity = 0.77). No technique, alone or in combination, can replace cystoscopy. However, alternate use of combined US and cytology with cystoscopy is efficient in the follow-up of bladder tumors and can reduce the number of cystoscopies. The delay in the diagnosis of recurrence probably has not negative negative influence on the history of the disease.