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Abstract
Bladder cancer is the most common cancer in Egypt and the fourth in men worldwide. It is more common in males. Several factors are involved in the development of bladder cancer including bilharzial cystitis; occupational exposure to chemicals; smoking; coffee; some analgesics and artificial sweeteners; bladder calculi, and genotoxic chemotherapeutic agents. Other genetic factors play a role such as p53, CK-20, Ki-67 and Rb genes.
Urothelial carcinoma is the most common pathological type worldwide and is becoming increasingly common in our country. Of this, superficial tumors represent about 70% of the initial diagnosed lesions.
It presents commonly by hematuria and irritative symptoms. Pelvi abdominal U/S and IVU are among other imaging modalities helping in diagnosis, but the standard method for diagnosis and treatment of superficial bladder cancer is cystoscopy and TURBT followed by pathological examination of resected tissues. Intravesical chemotherapy is followed by frequent cystoscopies are needed for follow up.
Voided urine cytology, is a noninvasive method to detect tumors and an adjunct to cystoscopy in the diagnosis and follow-up of superficial bladder cancer. It is highly specific and sensitive for high-grade lesions, but not sensitive for detecting low-grade disease. It also requires a trained cytopathologist.