Cystoscopic staging of carcinoma uterine cervix, revisited
Therattil, D.D.; Rao, M.S.
Journal of the Indian Medical Association 95(11): 582-583
1997
ISSN/ISBN: 0019-5847 PMID: 9567587 Document Number: 276578
The effectiveness of cysto-urethroscopy for the staging of cervical cancer was evaluated in a review of 412 cases of advanced squamous cell carcinoma referred to Kasturba Medical College Hospital (Manipal, India) in 1985-93. These cases were classified as follows: stage 3a (growth involving the lower third of the vagina without invasion of the pelvic wall), n = 19; stage 3b (invasion to the pelvic wall), n = 359; stage 4a (extension of disease to an adjacent organ), n = 17; and stage 4b (distal spread), n = 7. However, only 10 of the 378 stage-3 cases and 19 of the 24 stage-4 cases had histopathologically confirmed vesical mucosal involvement. All women underwent radiotherapy, regardless of the cystoscopic finding. Overall, this review suggests that cysto-urethroscopy is an unnecessary, cost-ineffective, invasive procedure that facilitates neither diagnosis nor treatment planning. Transvaginal sonography may be a preferable technique for evaluating vesical invasion, with use of cystoscopy reserved for endoscopic decompression of the obstructed ureter.