Jeya, R (2010) MDCT Virtual Cystoscopy with Conventional Cystoscopy in Bladder Tumors. Masters thesis, Madras Medical College, Chennai.
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Abstract
Primary bladder neoplasms account for 2%–6% of all tumors, with bladder cancer ranked as the fourth most common malignancy. Tumors may arise from the epithelial surface or any of the various layers of the bladder wall. The most common complaints in bladder disease are microscopic and macroscopic hematuria, dysuria and other voiding symptoms. Over 80% of patients with bladder cancer have hematuria, which is typically macroscopic and painless. Patients presenting with macroscopic hematuria should undergo thorough evaluation to determine the cause. Microscopic hematuria, defined as three or more red blood cells per high-power field from two of three urine specimens, is usually an incidental finding. According to the American Urological Association guidelines, patients with asymptomatic microscopic hematuria who have no evidence of primary renal disease and in whom benign causes such as menstruation, exercise, trauma, and infection have been excluded require urologic work-up. The guidelines recommend upper tract imaging evaluation with computed tomography (CT) or excretory urography and bladder evaluation with cystoscopy. Patients may also experience voiding symptoms such as frequency, dysuria, and pelvic pain and pressure. All these symptoms may also be related to inflammatory, stones, neurologic, obstructive or congenital abnormalities. Urogram, sonography (US), computed tomography (CT), magnetic resonant imaging (MRI) and some other radiological modality have been used for a long time in all these pathologies. However, conventional cystoscopy is a standard diagnostic approach for urinary bladder evaluation, its primary indication is the diagnosis of lower urinary tract disease, signs, and symptoms that may be related to the urinary tract are evaluated using cystoscopy to directly visualize lower urinary tract anatomy and macroscopic pathology. However, this procedure has drawbacks, including its high costs and an invasiveness that may lead to iatrogenic bladder injury and urinary sepsis. CONCLUSION : In conclusion, virtual CT cystoscopy is a promising technique for tumor and some other bladder lesions, such as diverticula. This minimally invasive method can be of value for screening, primary diagnosis and surveillance of bladder lesions. Virtual CT cystoscopy may be done as part of routine when ct urography is being done and it also may be done when conventional cystoscopy is contraindicated or restricted in feasibility and interpretation or there is risk of hemorrhage, perforation, or pain especially in young patients. It identifies abnormalities in the bladder as accurately as FC and is feasible in situations where FC could not be used bladder debris obscuring vision and when the patient could not tolerate the procedure. VC does not identify CIS. This can be seen as a major disadvantage of VC against FC. The one false-negative result was a result of the difficulty is assessing the mucosa in the presence of gross trabeculation.. The advantages of VC include being a totally noninvasive screening test for haematuria, evaluating both upper and lower urinary tracts, replacing several with one test it is possible to view the lesion from many directions and accurately locate and measure it. The data are stored electronically and can be repeated at any time and by different people in different places. VC allows simultaneous staging of the bladder tumor. It is possible now to create virtual ureteroscopic images from the same datasets and the abdominal organs are simultaneously screened. The processing time has decreased with new workstations, currently taking only a few minutes. The objective of the test is simply to define the patient groups who need further evaluation with RC. The disadvantages include the cost, radiation exposure .The urethra is visualized poorly and it is not possible to obtain histology.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | MDCT Virtual Cystoscopy ; Conventional Cystoscopy ; Bladder Tumors. |
| Subjects: | MEDICAL > Radio Diagnosis |
| Depositing User: | Subramani R |
| Date Deposited: | 30 Jun 2017 15:59 |
| Last Modified: | 30 Jun 2017 15:59 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/740 |
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