Introduction: Urinary bladder lesions constitute an important source of clinical signs and symptoms which are more disabling than lethal. The present study aimed to study the frequency of bladder lesions and to study the clinicohistomorphological features of various bladder lesions with special emphasis on grading and staging of the bladder tumours.
Materials and methods:The present study is a 3 years prospective study carried out in the department of pathology. All patients who visited to urology outpatient department with lower urinary tract symptoms and obstructive bladder symptoms were subjected to cystoscopy. The detailed clinico-histomorphological features of cystoscopy biopsies are studied using WHO/ISUP 2004 histological grading and TNM staging are used in classifying the bladder tumours.Results: Out of 139 cystoscopy biopsies, the non-neoplastic bladder lesions constituted 26.6 % and neoplastic lesions constituted 73.38%. Among the neoplastic, benign lesions showed 10.79% of the cases and malignant lesions showed 62.58% of the cases. Among the malignant lesions, urothelial carcinoma was the commonest accounting for 55.39% of the cases with increased prevalence of high grade papillary urothelial carcinoma (55.43%) and invasive papillary urothelial carcinoma accounting for 78.25% of the cases.
Conclusions:The present study has stressed the importance of Histopathological examination with special emphasis on the study of serial sections, inclusion of smooth muscle in the biopsy for accurate grading and staging so as to decrease the mortality and morbidity due to bladder tumours. All the patients who visited the urology outpatient department (OPD) with lower urinary tract symptoms and obstructive urinary symptoms were included in the study. After the informed written consent of the patients, fiberoptic cystoscopy bladder biopsies were taken from the walls of the bladder. The cystoscopic bladder biopsies taken were fixed in 10% buffered formalin and then processed with embedding in paraffin wax. Four microns thick sections were taken and stained with regular haematoxylin and eosin stain (H and E). The study of biopsy specimens along with the histomorphological changes under low and high power magnification were studied by light microscope. The WHO/ISUP -2004 grading system was used to grade the bladder neoplasms 7 and staging was done according to TNM staging [7].
Keywords:Inclusion criteria: All the transurethral resection of bladder tissue (TURBT) biopsies received in the department of pathology.Exclusion criteria: Autolysed and inadequate biopsies were excluded.
ResultsOut of total 139 cases, 71cases (51.1%) were males and 68 cases (48.9%) were females with peak age incidence is between 60-69 years as shown in graph 1. In the study, we found that the majority of the patients with benign lesions presented with lower urinary tract symptoms (LUTS) accounting for 82.7% of the cases and those with malignant lesions present with haematuria accounting for 90.8% of the cases as shown in graph 2. The detai...