Control for recurrences of urinary bladder tumours by transabdominal ultrasonic scanning

By transabdominal ultrasonic scanning of the filled bladder it is possible to examine the surface of the bladder urothelium in the outpatient clinic. In a "blind" study of 129 patients controlled for recurrences of urinary bladder tumours the results of dynamic transabdominal ultrasonography were compared with the results of cystoscopy. The ultrasound could identify the recurrences of 5 mm or above in size significantly. Below 5 mm in dimension, when positioned in the dome of the bladder or at severe trabeculation the ultrasonic scanning lead to a misdiagnosis. No invasive recurrences were overlooked by ultrasonography. We will advocate that transabdominal ultrasonic scanning replace routine cystoscopy in low-risk patients with superficial bladder tumours of the Ta category and a low grade after the primary transurethral treatment and no or few recurrences of the same Ta category at the first control cystoscopy. On the other hand we will recommend to continue cystoscopy of patients with frequently recurring urinary bladder tumours, the high grade Ta tumours, carcinoma in situ because of the risk of invasive growth, and patients with primary invasive tumours including those with the superficial invasion (category T1).