Random mucosal biopsies in the evaluation of patients with carcinoma of the bladder

The management of patients with recurrent transitional cell carcinoma of the bladder has posed a constant dilemma to the practicing urologist. Previously, urine cytologies have been used and have been of value only in those instances in which they have been classified as diagnostic. Cytologies that reveal atypia or a high degree of suspicion have offered little help in the management of these patients. The current procedure of doing random mucosal biopsies using the cold cup biopsy forceps provides the pathologist with a sampling of the mucosa of the involved bladder so that a tissue diagnosis of sufficient magnitude, ranging from atypia to carcinoma in situ to frank carcinoma, may be established. This information may become valuable in determining alternate forms of management in these patients and may have a greater predictive value than customary urine cytology.