Association of urine cytology and cystoscopy findings with histologic diagnosis of urinary bladder lesions

Objectives: Neoplastic urinary bladder lesions are responsible for significant morbidity and mortality throughout the world. The diagnostic armentarium used by the urologists for urinary bladder lesions includes urinary cytology, cystoscopy, and biopsy. This study aims at studying the histopathological spectrum of urinary bladder lesions and associating it with findings of precystoscopy urine cytology and cystoscopy. Material and Methods: This observational study was carried out for 18 months, including the patients presenting with urinary bladder complaints, who attended the hospital and underwent relevant procedures. Results: It was noted that maximum cases, that is, 36 (49.3%) in which biopsy/transurethral resection of bladder tumor was done were diagnosed as high-grade urothelial carcinoma and 31 cases (42.5%) were cases of low-grade urothelial carcinoma suggesting that intervention is normally done in cases with suspicion of malignancy or in later stages of the disease. The overall sensitivity of the urine cytology, taking histopathology as the gold standard, was seen to be 72% and specificity was seen to be 80%. Furthermore, it was noted that cystoscopy findings which suggested large lesions (>3 cm) or multiple lesions were seen to be malignant on histopathology, making the sensitivity of cystoscopy quite high. Conclusion: In the end, it was concluded that bladder carcinoma is most commonly seen in males and in the age group of 51–60 years, with hematuria being the most common complaint. Urine cytology, despite being used to correctly detect malignancy, could not be used to comment on the grade of malignancy. Although, urine cytology in conjunction with cystoscopy can work as a good diagnostic aid in differentiating malignant from non-malignant lesions. However, for commenting on the invasiveness and the typing of the malignancy, histopathology remains the gold standard.