Abnormal Urine Cytology Research Articles

Unusual Presentation of Ureteral Hunner Lesion: A Case Report

This case report presents a rare and atypical manifestation of a ureteral Hunner lesion (HL). The patient initially presented with right ureteral stenosis, abnormal urine cytology, intermittent flank pain, gross hematuria, and lower urinary tract symptoms. Diagnostic evaluation involved various imaging studies, endoscopic procedures, and medical interventions. Eventually, the patient underwent right segmental ureterectomy resulting in symptom improvement. Pathology revealed findings consistent with a HL. This case report highlights the challenges in diagnosis, management, and the importance of considering ureteral HL as a potential cause of ureteral symptoms.

Intravesical recurrence factors and outcome after radical nephroureterectomy for upper tract urothelial carcinoma: Multivariate analysis with propensity score matching.

ObjectiveThe risk factors for intravesical recurrence (IVR) after radical nephroureterectomy (RNU) in patients with upper tract urothelial carcinoma (UTUC) remain inconsistent and unclear. Thus, the risk factors of IVR after RNU and the prognostic significance of the risk indicators were explored herein.MethodsWe retrospectively analyzed UTUC patients upon RNU in our center from January 2009 to December 2019. After propensity score matching, 139 patients were included in this study. Univariate and multivariate Cox proportional hazard regressions were used to estimate the hazard ratio and 95% confidence intervals. Overall survival (OS), cancer-specific survival (CSS) and recurrence-free survival (RFS) were measured using the Kaplan–Meier curve with a log-rank test. A P-value < 0.05 was considered statistically significant.ResultsWe included 139 patients with a median follow-up of 42 months, of which 48 patients had an intravesical recurrence. Multivariate Cox regression analysis showed cytological abnormalities in urine (HR=3.101, P=0.002), hydronephrosis (HR=1.852, P=0.042), adjuvant chemotherapy (HR=0.242, P<0.001), and previous history of bladder cancer (HR=5.51, P<0.001) were independent risk factors for IVR. As for clinical outcomes, OS and CSS suggested disadvantages in patients with IVR compared with patients without recurrence (P=0.042 for OS, P<0.0001 for CSS), OS of patients with abnormal urine cytology and OS and CSS of patients receiving adjuvant chemotherapy did not present clinical significance, and other risk factors all affected the clinical outcome.ConclusionIn this propensity-score matching study, cytological abnormality of urine, hydronephrosis, adjuvant chemotherapy and previous history of bladder cancer were shown to be independent risk factors for IVR. Moreover, risk factors also influence clinical outcomes, thereby rendering it necessary to adopt more active postoperative surveillance and treatment strategies for these patients, which may help improve treatment outcomes.

Developing a Machine Learning Algorithm for Identifying Abnormal Urothelial Cells: A Feasibility Study

Introduction: Urine cytology plays an important role in diagnosing urothelial carcinoma (UC). However, urine cytology interpretation is subjective and difficult. Morphogo (ALAB, Boston, MA, USA), equipped with automatic acquisition and scanning, optical focusing, and automatic classification with convolutional neural network has been developed for bone marrow aspirate smear analysis of hematopoietic diseases. The goal of this preliminary study was to determine the feasibility of developing a machine learning algorithm on Morphogo for identifying abnormal urothelial cells in urine cytology slides. Methods: Thirty-seven achieved abnormal urine cytology slides from cases with the diagnosis of atypical urothelial cells and above (suspicions or positive for UC) were obtained from 1 hospital. A pathologist (J.R.) reviewed the slides and manually selected and annotated representative cells to feed into Morphogo with following categories: benign (urothelial cells, squamous cells, degenerated cells, and inflammatory cells), atypical cells, and suspicious cells. Initial validation of the algorithm was performed on a subset of the original 37 cases. Urine samples from additional 12 unknown cases with various histological diagnoses (6 cases of high-grade urothelial carcinoma (HGUC), 1 case of low-grade urothelial carcinoma (LGUC), 1 case of prostate adenocarcinoma, 1 case of renal cell carcinoma, and 4 cases of non-neoplastic conditions) were collected from another hospital for initial blind testing. Results: A total of 1,910 benign and 1,978 abnormal (atypical and suspicious) cells from 37 slides were annotated for developing and training of the algorithm. This algorithm was validated on 27 slides that resulted in identification of at least 1 abnormal cell per slide, with a total of 200 abnormal cells, and an average of 7.4 cells per slide. Of the 12 unknown cases tested, the original cytology was positive for tumor cells in 2 HGUC samples. Morphogo was abnormal (atypical or suspicious) for 6 samples from patients with UC, including one with LGUC and one with prostate adenocarcinoma. Conclusion: Morphogo machine learning algorithm is capable of identifying abnormal urothelial cells. Further validation studies with a larger number of urine samples will be needed to determine if it can be used to assist the cytological diagnosis of UC.

Photodynamic diagnostic ureterorenoscopy: A valuable tool in the detection of upper urinary tract tumour

BackgroundPhotodynamic diagnosis increases the detection rate and hence decreases recurrence rates of urothelial cancer (UC) of the bladder. This technique has been implemented in the upper urinary tract and like in the bladder, has shown to increase the detection rate of urothelial lesions. ObjectivesTo determine the sensitivity, specificity, and detection rates for photodynamic diagnostic flexible ureterorenoscopy (PDD-FURS) and white light ureterorenoscopy (WL-FURS).Design between 2009 and 2013, PDD-FURS was performed within 106 Upper urinary tract (UUT) Units (Mean age—72.6±9.5). Indications for the procedure included abnormal upper urinary tract on imaging, normal flexible cystoscopy with abnormal urine cytology, endoscopic treatment and follow-up of UUT UC. Oral 5-aminolevulinic acid was used as the photosensitizer administered 3-4h pre-operatively. Results48 lesions were detected, of which 95.8% (46/48) where visualised by PDD-FURS compared to 47.9% (23/48) shown by WL-FURS (P<0.0001). PDD-FURS detected significantly more carcinoma in situ (CIS) or dysplasia lesions than WL-FURS (93.75% (15/16) vs. 18.75% (3/16), respectively, (P=0.0006)). Furthermore, PDD-FURS detected significantly more UC lesions than WL-FURS (96.9% (31/32) vs. 62.5% (20/32) (P=0.007)).PDD-FURS was more sensitive (95.8; range: 85.7–99.5) than WL-FURS (53.5; range: 37.7–68.8) in detecting UUT-UC (P<0.0001). There was no difference (P=0.716) in the specificity between PDD-FURS (96.6; range: 88.1–99.6) and WL-FURS (95.2; range: 86.7–99). ConclusionsOur results PDD-FURS with oral 5-ALA as photosensitizer suggest higher sensitivity and detection rate of urothelial tumours than WL-FURS, with a good safety profile. In our series, PDD-FURS enhanced the visualisation of flat lesions, such as CIS and dysplasia that otherwise would have been missed.

Evaluation of Enteric Urine Specimens: Challenging Specimens in a High Risk Population

Introduction: To improve prognostic value and enable more standardized clinical management, our group has recently developed a standardized template for urologic tract (UT) cytology specimens. We now examine the application of this template to enteric urine specimens. These specimens create a diagnostic challenge due to the often rarity of urothelial cells compared to enteric contaminant and increased degenerative changes. These patients are at high risk for recurrence and screening methods, including endoscopy, are technically difficult due to the altered anatomy, making accurate cytologic diagnosis particularly crucial in these specimens. Materials and Methods: The database was searched over a 10-year period to identify enteric urologic specimens with evidence of high grade urothelial carcinoma [HGUC]or atypical urothelial cells. Cytologic characteristicswere evaluated along with clinical data including prior history of carcinoma, surgical resection/reconstruction, pathologic staging/diagnosis, and the role of abnormal urine cytology in guiding subsequent treatment decisions. Results: 11 patients with 19 instances of abnormal urine cytology were identified. Most cases represented recurrence of HGUC following radical cystoprostatectomy, with one case of adenocarcinoma. All patients were male and had reconstruction with ileum, 3 of which were orthotopic neobladders. The median age was 72 and the median time to recurrence from cystectomy was 16 months. 6 of 11 patients were deceased at the time of analysis, all with extensive metastatic disease. Of those that were deceased, median time from positive cytology to death was 2.2 years. When the site of recurrence could be detected, it was close to the prior ureteral anastomosis in 5 cases and amenable to surgical treatment. Conclusions: Patients with recurrent HGUC following radical cystoprostatectomy have a high rate of mortality with limited treatment options. Our findings demonstrate that positive urine cytology may frequently identify surgically-resectable recurrences, suggesting these patients may benefit from close follow-up and standardized evaluation.

Performance of Urinary Cytology (UCy) In Monitoring for Local Tumor Recurrence (LTR) Following Radical Cystectomy and Urinary Diversion (RC-UD) for Urothelial Carcinoma (UCa) of Urinary Bladder

Introduction: To improve prognostic value and enable more standardized clinical management, our group has recently developed a standardized template for urologic tract (UT) cytology specimens. We now examine the application of this template to enteric urine specimens. These specimens create a diagnostic challenge due to the often rarity of urothelial cells compared to enteric contaminant and increased degenerative changes. These patients are at high risk for recurrence and screening methods, including endoscopy, are technically difficult due to the altered anatomy, making accurate cytologic diagnosis particularly crucial in these specimens. Materials and Methods: The database was searched over a 10-year period to identify enteric urologic specimens with evidence of high grade urothelial carcinoma [HGUC]or atypical urothelial cells. Cytologic characteristicswere evaluated along with clinical data including prior history of carcinoma, surgical resection/reconstruction, pathologic staging/diagnosis, and the role of abnormal urine cytology in guiding subsequent treatment decisions. Results: 11 patients with 19 instances of abnormal urine cytology were identified. Most cases represented recurrence of HGUC following radical cystoprostatectomy, with one case of adenocarcinoma. All patients were male and had reconstruction with ileum, 3 of which were orthotopic neobladders. The median age was 72 and the median time to recurrence from cystectomy was 16 months. 6 of 11 patients were deceased at the time of analysis, all with extensive metastatic disease. Of those that were deceased, median time from positive cytology to death was 2.2 years. When the site of recurrence could be detected, it was close to the prior ureteral anastomosis in 5 cases and amenable to surgical treatment. Conclusions: Patients with recurrent HGUC following radical cystoprostatectomy have a high rate of mortality with limited treatment options. Our findings demonstrate that positive urine cytology may frequently identify surgically-resectable recurrences, suggesting these patients may benefit from close follow-up and standardized evaluation.

Pelvic Mass 21 Years after Total Hip Arthroplasty

Background. Long-term urologic complications after total hip arthroplasty are rare, and reports in the urologic literature are scant. We present a recent case and review the relevant literature. Case. A 77-year-old man was referred to the urology clinic for a single episode of gross painless hematuria, abnormal urine cytology, and pelvic mass. He had a significant smoking history. Surgical history included right total hip arthroplasty 21 years prior. Results. Pelvic ultrasound revealed a large mass abutting the right bladder wall. Subsequent computed tomography indicated that the mass was extrinsic to the bladder. Results of computed tomography-guided biopsy of the mass were consistent with foreign body granuloma. Surveillance imaging confirmed no growth or progression, and intervention was deferred. Conclusion. Long-term complications of total hip arthroplasty may present with signs and symptoms of urologic disease. Reports in the urologic literature are rare.

Unilateral Urological Double Cancer after Kidney Transplantation

In organ transplant patients, the high incidence of malignancy is well known. Here we experienced a simultaneous double cancer may occur after renal transplantation in the urinary tract. The patient was a 64-year-old woman. Diagnosis of renal failure undergoing Toxemia of pregnancy in 1971. Be introduced as end stage renal disease undergoing hemodialysis since 1978. Living donor kidney transplant performed in March 1980(The donor was her father). Renal transplantation immunosuppressive therapy was introduced azathioprine · methylprednisolone. Current maintenance immunosuppressive therapy is Mizoribine · methylprednisolone. Renal function after transplantation (2.3 to value 2.5 Serum creatinine) had remained in good condition. Admitted in January 2011, gross hematuria thereafter. No abnormal urine cytology tests, especially since no observation was also asymptomatic. Again showed gross hematuria in May 2011. Subject to the inspection report positive urine cytology again. Admitted to a space-occupying lesion in the left renal pelvis examination CT. Resection underwent left nephroureterectomy, July 29, 2011 left kidney tumor was diagnosed. Ureter were removed at the intersection of the left iliac artery. Pathological diagnosis of renal tissue excised Clear cell carcinoma, pT3a, G1> G2, Fuhrman grade 1, was INFa. Pathological diagnosis of the ipsilateral ureter was excised similarly invasive urothelial carcinoma of It ureter, G2, INFb, were pT1. Ureteral stump pathologic findings were observed in excised malignancy. Postoperative renal graft function is stable even without any particular change. We had have to be continued careful watching in our outpatient clinic. We report an example of urinary tract cancers occurring simultaneously in one side to the urinary tract 21 years after renal transplantation.

Reflex UroVysion Testing for Abnormal Urine Cytology: Experience From an Academic Medical Center

Reflex UroVysion Testing for Abnormal Urine Cytology: Experience From an Academic Medical Center

The Significance of Persistent Abnormal Urine Cytology

Purpose: We investigated the factors that predicted later transitional cell carcinoma (TCC) in a subgroup of patients with abnormal cytology and negative initial evaluations. Materials and Methods: From January 2002 to June 2007, we retrospectively identified 58 patients. Cases were considered discordant if a work-up of urine cytology was abnormal although initial cystoscopy, upper tract evaluation, and biopsies resulted in a negative or benign diagnosis. Patients who could complete a urine cytology test after 6 to 8 weeks and who were followed up for at least 1 year were included in this study. According to later TCC demonstration, we compared risk factors for TCC between the later TCC group and the benign group and evaluated the independent factors that predicted later TCC by use of a Cox proportional hazards regression model. Results: Of the 58 patients, the mean follow-up was 12.7±17.3 months (range: 2-83 months), and 14 patients (23.7%) had a prior history of TCC. During follow-up, 9 patients (15.3%) had TCC and 1 patient had prostate cancer. In the later TCC group, the incidence of a prior history of TCC (p=0.03) and persistent abnormal cytology (p<0.001) were higher than in the benign group in univariate analysis. In the Cox proportional hazards regression model, persistent abnormal cytology (p=0.033, relative risk (RR): 17.380 [95% CI: 1.265-238.783]) was the only independent factor to predict later TCC. The mean follow-up duration of later TCC demonstration was 8.55 months (range: 2-32 months). Conclusions: Our results suggest that in the setting of persistent abnormal urine cytology with a negative initial evaluation, 53.3% of patients will later develop TCC. Patients with persistent abnormal cytology need intensive follow-up within 1 year. (Korean J Urol 2009;50:125-129) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

POLYOMA VIRUS HEMORRHAGIC CYSTITIS IN AN OTHERWISE NORMAL CHILD

We describe a case of polyoma virus hemorrhagic cystitis in a nonimmunosuppressed child. Polyoma virus infection was suspected because of abnormal urine cytology. Polyoma virus cystitis in nonimmunosuppressed children is self-limited, resolving spontaneously within 2 weeks.

1091: Analysis of Cases with Abnormal Urine Cytology and Normal Histologic Findings Over a Five Year Period

1091: Analysis of Cases with Abnormal Urine Cytology and Normal Histologic Findings Over a Five Year Period

Urine cytology as a screening test for bladder infiltration in cervical cancer

Ultrasound is currently used as a screening test for bladder infiltration in patients with advanced-stage cervical cancer at our institution. Cystoscopy is reserved for patients with abnormal bladder ultrasound findings. This study was undertaken to reevaluate this policy and to compare the results of different screening tests. The study was carried out in Pretoria academic complex. All newly diagnosed cervical carcinoma patients stage II and above were included in this study. The standard staging investigations were done on all patients. In addition, urine midstream and catheter specimens were sent for cytology. Cystoscopy and biopsy were performed on all patients. Two hundred twenty-eight patients were enrolled into this study. At cystoscopy, 47 patients had bladder mucosa suspicious of malignant infiltration, of which 17 had bladder mucosa infiltration diagnosed on histology. Urine catheter cytology has a sensitivity of 94% and specificity of 82% for bladder mucosa infiltration. The predictive value of a positive test is 31% and for a negative test is 99%. Catheter urine cytology is a very useful screening test for bladder infiltration in patients with cervical cancer. Cystoscopy should be reserved for patients with abnormal urine cytology in resource-poor settings with a large burden of disease.

Ureteral cancer associated with dermatomyositis

Dermatomyositis is a rare inflammatory myopathy that has characteristic cutaneous lesions. Although many malignancies are associated with dermatomyositis, urogenital malignancies have rarely been reported to be associated with dermatomyositis. We report here on the first case of ureteral cancer associated with dermatomyositis. A 42-year-old man presented to us with a skin rash. A clinical diagnosis of dermatomyositis was made due to the skin lesions, muscle weakness, arthralgia, the increased erythrocyte sedimentation rate and the increased creatine kinase level. The patient revealed microscopic hematuria and abnormal urine cytology during the investigation for the underlying malignancy. Retrograde pyelography demonstrated a suspicious lesion in the right mid-ureter, and the ureteroscopic biopsy revealed the urothelial carcinoma. Although an operation was recommended, the patient died of pneumonia associated with his interstitial lung disease, which is one of the poor prognostic indicators of dermatomyositis.

The UroVysion fluorescence in situ hybridization assay is an effective tool for monitoring recurrence of bladder cancer

The newly developed UroVysion fluorescence in situ hybridization (FISH) probe was applied to urine specimens from 19 patients being monitored for recurrence of bladder cancer. The results for the multi-target DNA FISH assay were compared with independent analyses of urine cytology and flexible cystoscopy. Patients with tumors identified through the cystoscopy exam were biopsied and/or underwent surgery. In 12 patients with normal cytoscopy, cytology and FISH were also normal. Therefore, the specificity of these two tests was 100%. In 7 patients, a tumor was diagnosed by cystoscopy, and 3 of them had abnormal urine cytology while 6 of them had an abnormal result in the FISH assay. Accordingly, the sensitivity was 43% for the cytology and 87% for the FISH test. Interestingly, a pT1G3 tumor in a bladder diverticulum was not detected by cytology or the FISH test. These results agreed with a large series previously published using similar FISH probes and support the proposal for a multicenter trial to confirm the usefulness of the UroVysion probe as a screening tool to select patients for cystoscopy.

Author reply

We thank Dr. Sier and colleagues for their candid letter regarding our study.1 We chose not to control for kidney function; this decision was based on the assumption that for a marker to be clinically useful and to add predictive information to the information yielded by current tests, the marker should have a robust performance in all patients regardless of kidney function. We found that increased urine levels of urokinase (uPA) were associated with an increased risk of bladder carcinoma, whereas urine levels of the urokinase receptor (uPAR) were not. Urine levels of uPA have not been shown to fluctuate from sampling to sampling. Therefore, we concluded that urine levels of uPA represent a potentially valuable marker for bladder carcinoma detection. We found no association between urine levels of uPAR and the presence of bladder carcinoma or pathologic features. In our opinion, this finding, together with the dependence of urine levels of uPAR on sampling time (as Dr. Sier and colleagues appropriately have noted), supports the idea that urine levels of uPAR possess limited clinical utility in the diagnosis, staging, and management of bladder carcinoma. To address the specific issue raised by Dr. Sier and colleagues, we retrieved the majority of the samples used in the original study and repeated the analysis with adjustments for creatinine levels. Using a system manufactured by Olympus America (Melville, NY), we measured creatinine levels for 170 of the original 229 patients in the voided urine samples used for measurement of uPAR and uPA levels. The mean urine creatinine concentration was standard deviation (SD) 73.1 ± 46.4 mg/dL (median, 65.2 mg/dL; range, 9.8–236.1 mg/dL). All samples were run in duplicate, with the mean value used for data analysis. Differences between duplicate measurements were minimal, as indicated by the intraassay precision coefficient of variation, which was equal to SD 5.8 ± 8.7%. Levels of uPA and uPAR (both in ng/mL) were divided by urine levels of creatinine (in mg/dL) to adjust for the effect of kidney function. We found that both the uPA/creatinine ratio (P < 0.001) and the uPAR/creatinine ratio (P = 0.010) were greater in patients with bladder tumors compared with control patients. However, whereas there were significant differences between case patients and control patients in terms of the quartile distributions of the uPA/creatinine ratio (P = 0.002), there were no such differences with respect to the uPAR/creatinine ratio. In addition, uPA/creatinine ratios were higher among patients with abnormal urine cytology findings (P = 0.038), whereas uPAR/creatinine ratios were not associated with any clinicopathologic characteristics. The uPAR/creatinine ratio was significantly (but moderately) correlated with urine uPAR levels (correlation coefficient [CC], 0.496; P < 0.001), and the uPA/creatinine ratio was strongly correlated with urine uPA levels (CC, 0.904; P < 0.001). In univariate logistic regression analyses, uPA/creatinine ratio (P < 0.001), age (P < 0.001), and positive urinary cytology (P = 0.006), but not uPAR/creatinine ratio, were found to be associated with an increased risk of transitional cell carcinoma of the bladder. Using a multivariate logistic regression model, with adjustments made for the effects of urine uPAR levels and age, only increased uPA/creatinine ratio (P = 0.003) and positive cytology (P < 0.001) were found to be associated with the presence of bladder carcinoma. In conclusion, we confirmed that increased urine levels of uPA are associated with the presence of bladder carcinoma, regardless of kidney function, and that urine levels of uPAR are not associated with bladder carcinoma, even after adjustments for urine levels of creatinine are made. Shahrokh F. Shariat M.D.*, Seth P. Lerner M.D. , Roberto Casella M.D. , * Department of Urology University of Texas Southwestern Medical Center Dallas, Texas, Scott Department of Urology Baylor College of Medicine Houston, Texas, Department of Urology University Hospital Basel, Switzerland.

EOSINOPHILIC CYSTITIS IN ADULTS

We describe the largest clinical experience with the diagnosis and management of largely anecdotally reported eosinophilic cystitis. Five women and 12 men 18 to 84 years with proved eosinophilic cystitis were treated in a 23-year period. Some combination of hematuria, irritative voiding, dysuria and suprapubic pain was present in 14 cases (82%). The remaining 3 patients (18%) were asymptomatic and the diagnosis was made by cystoscopy done because of a history of bladder carcinoma. Available data included no peripheral eosinophilia in 10 of 10 patients studied, pyuria in 12 (92%), microhematuria in 11 of 13 (84%), sterile urine in all 17, abnormal urine cytology in 2 of 17 (12%), bilateral hydronephrosis in 1 and a bladder mass or thickening in 2. Cystoscopy showed erythema in all cases and tumor-like lesions or edema in 3 (17.6%). Histological studies revealed eosinophilic cystitis in all 17 patients, while in 1 with no history of bladder carcinoma eosinophilic cystitis coexisted with carcinoma. Two patients were lost to followup and the remaining 15 were followed 1 to 37 months. After biopsy and fulguration of the lesions 10 patients received no further treatment, including 6 with complete symptom resolution and 1 with improvement. The 3 asymptomatic patients with a history of bladder carcinoma remained asymptomatic and disease-free. Another 4 patients underwent medical therapy and improved, of whom 1 had recurrence that was successfully re-treated medically. The remaining patient, who was symptomatic, underwent cystoprostatectomy for end stage bladder disease. Manifestations of eosinophilic cystitis indistinguishably mimic those of other inflammatory and malignant bladder disorders that may precede or coexist with it. The condition usually follows a benign course in most cases but occasionally its relentless progression causes crippling disease.

The role of urine cytology in the assessment of lower urinary tract symptoms.

To evaluate the role of urine cytology in the investigation of men with lower urinary tract symptoms (LUTS) in the absence of haematuria. The study comprised 336 men attending a LUTS assessment clinic, who had neither macroscopic nor microscopic haematuria. One sample of urine was collected for cytology. Those with suspicious urine cytology were investigated with intravenous urography and cystoscopy. Five men had abnormal urine cytology results; on further investigation one of them was found to have carcinoma in situ (CIS) and one to have a transitional cell carcinoma. Three had false-positive urine cytology results. A bladder tumour or CIS was detected in 0.6% of the population tested. The cost per cancer diagnosed was GB pound 2020. Urine cytology is a simple noninvasive way of assisting accurate diagnosis of men who have LUTS in the absence of haematuria.

Late malignancy in bowel segments exposed to urine without fecal stream

This study was constructed so as to screen malignant transformation after uroenteric reconstructions using bowel segments exposed to urine without fecal stream for more than 10 years. Follow-up data were available for 186 patients who underwent various uroenteric reconstructions using bowel segments exposed to urine without fecal stream for more than 10 years. There were 68 eligible patients with isolated rectosigmoid bladder, 23 with bladder augmentations (15 ileocystoplasty and 8 colocystoplasty), 57 with ileal ureter, and 38 with ileal loop conduit. Besides routine laboratory and radiologic investigations, urine for cytology was obtained from all patients. Moreover, endoscopy and random biopsy of the part of bowel exposed to urine were carried out in all patients. Uroenteric malignancy was diagnosed in 4 patients (2%): 2 adenocarcinoma in an isolated rectosigmoid bladder, 1 transitional cell carcinoma following augmentation colocystoplasty, and 1 squamous cell carcinoma after ileal ureter. None of the patients developed tumors in ileal loop conduits. Malignant changes do not only occur after ureterosigmoidostomy but are also observed after different uroenteric reconstructions not exposed to fecal stream. Hematuria, ureteral obstruction, and abnormal urine cytology are warning signs of malignancy. Routine cytology is recommended at least yearly beginning 10 years after surgery.

B2 MICROGLOBULIN EXCRETION IN GLOMERULONEPHRITIS (GN), ANALGESIC NEPHROPATHY (AN), AND A.N. WITH ABNORMAL URINE CYTOLOGY

Australian and New Zealand Journal of MedicineVolume 10, Issue 1 p. 131-131 B2 MICROGLOBULIN EXCRETION IN GLOMERULONEPHRITIS (GN), ANALGESIC NEPHROPATHY (AN), AND A.N. WITH ABNORMAL URINE CYTOLOGY G.R. Russ, G.R. Russ Red Unit, The Queen Eliznbeth Hospital, Woodville, South AustraliaSearch for more papers by this authorB.A. Horgan, B.A. Horgan Red Unit, The Queen Eliznbeth Hospital, Woodville, South AustraliaSearch for more papers by this authorT.H. Mathew, T.H. Mathew Red Unit, The Queen Eliznbeth Hospital, Woodville, South AustraliaSearch for more papers by this author G.R. Russ, G.R. Russ Red Unit, The Queen Eliznbeth Hospital, Woodville, South AustraliaSearch for more papers by this authorB.A. Horgan, B.A. Horgan Red Unit, The Queen Eliznbeth Hospital, Woodville, South AustraliaSearch for more papers by this authorT.H. Mathew, T.H. Mathew Red Unit, The Queen Eliznbeth Hospital, Woodville, South AustraliaSearch for more papers by this author First published: February 1980 https://doi.org/10.1111/j.1445-5994.1980.tb03503.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume10, Issue1February 1980Pages 131-131 RelatedInformation