Routine surveillance cystoscopy for patients with augmentation and substitution cystoplasty for benign urological conditions: is it necessary?
| Autor: | Alexander Freeman, Janine Nethercliffe, Tamsin Greenwell, Christopher Woodhouse, Rizwan Hamid, Suzie N. Venn |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Urology Urinary system medicine.medical_treatment Unnecessary Procedures Urinary Diversion Malignancy Young Adult Ureterosigmoidostomy Postoperative Complications Cystitis medicine Humans Aged Hematuria medicine.diagnostic_test business.industry Urinary Reservoirs Continent Urinary diversion Urinary Bladder Diseases Cystoscopy Middle Aged medicine.disease Long-Term Care Cystoscopies Surgery Endoscopy Transitional cell carcinoma Urinary Bladder Neoplasms Female Epidemiologic Methods business |
| Zdroj: | BJU International. 104:392-395 |
| ISSN: | 1464-410X 1464-4096 |
| DOI: | 10.1111/j.1464-410x.2009.08401.x |
| Popis: | OBJECTIVETo evaluate screening cystoscopy as the long-term follow up in patients with an enterocystoplasty for >= 10 years.PATIENTS AND METHODSWe 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.RESULTSThe 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.CONCLUSIONSWe 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. |
| Databáze: | OpenAIRE |
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