Role of ultrasonography and urinary cytology in diagnosing recurrence of superficial urinary bladder cancer compared to cystoscopy.

Urinary cytology, ultrasonogram of the urinary bladder and cystoscopy were done in 99 cases of urinary bladder cancer patients in the department of urology of Dhaka Medical College Hospital (DMCH), Dhaka, during the period from January 1997 to December 1998. Pre transurethral resection of bladder tumour (TURBT), urinary cytology was positive in 20.20% cases and ultrasound scan was positive in 96.9% cases. Histopathological examination revealed 95.96% as transitional cell carcinoma:- Grade I (3.0%), Grade II (62.6%) and Grade III (34.4%). During follow-up urinary cytology was positive in only one case whereas ultrasound scan was positive in 53.5% cases of whom only 21.6% patients had actual recurrent bladder tumours proved by cystoscopy. Statistical analysis of the three tests and histopathology showed significant variation though by Chi-square test the ultrasound scan is found superior to urinary cytology. We conclude when ultrasonography of the urinary bladder shows any suspected lesion it should be examined by cystoscope and biopsy should be taken from the suspected area for confirmation. Neither urinary cytology nor ultrasound scan can replace cystoscopic examination.