Diagnostic efficacy of the combination of urine cytology, urine analysis and history in the follow-up of bladder carcinoma.

In the follow-up of low stage, low grade transitional cell carcinoma of the bladder, cystoscopy is used as a diagnostic standard. Because of the lack of well defined prognostic parameters, cystoscopic follow-up is based upon empirical grounds. In this study, 82 patients with a primary superficial transitional cell carcinoma of the bladder were studied with respect to the time interval before recurrence. The mean number of cystoscopies leading to detection of recurrence (i.e. the ratio of positive to negative cystoscopy) was reviewed. Eighteen cystoscopies had to be done to detect each recurrence. Because of this excessive number of cystoscopies, the diagnostic value of the combination of red cell count in urine, cytology and history of micturition symptoms and haematuria was assessed in a retrospective study of 86 recurrences of bladder carcinoma. The results indicated that the combination of these non-invasive diagnostic tests may constitute a sensitive procedure for the follow-up of bladder tumours. In the case of T1G3 and muscle-invasive recurrences (greater than T1), the sensitivity rate was 100%.