Sammer Ulla, Walter Matthias, Knüpfer Stephanie C, Mehnert Ulrich, Bode-Lesniewska Beata, Kessler Thomas M
Neuro-Urology, Spinal Cord Injury Center and Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland.
Institute of Surgical Pathology, University of Zürich, University Hospital Zürich, Zürich, Switzerland.
PLoS One. 2015 Oct 29;10(10):e0140970. doi: 10.1371/journal.pone.0140970. eCollection 2015.
To examine the value of surveillance urethro-cystoscopy in patients with neurogenic lower urinary tract dysfunction (NLUTD) in regard to the conflicting literature as it is generally agreed that patients with NLUTD are at increased risk for bladder cancer.
In a cross-sectional study, a consecutive series of 129 patients (50 females, 79 males, mean age 51, range 18-88) suffering from NLUTD for at least 5 years was prospectively investigated using urethro-cystoscopy and bladder washing cytology at a single university spinal cord injury (SCI) center.
Due to suspicious urethro-cystoscopy and/or bladder washing cytology findings, 13 (10%) of 129 patients underwent transurethral resection of the bladder lesion and/or random bladder biopsies. Overall, 9 relevant histological findings were found in 5% (7/129) of our patients: bladder melanosis (n = 1), nephrogenic adenoma (n = 3), keratinizing squamous metaplasia (n = 1), intestinal metaplasia (n = 3), and muscle-invasive adenocarcinoma of the bladder (n = 1).
Using surveillance urethro-cystoscopy, we found relevant histological findings in 5% of our patients suffering from NLUTD for at least 5 years. Thus, surveillance urethro-cystoscopy might be warranted, although the ideal starting point and frequency remain to be determined in further prospective studies.
鉴于关于神经源性下尿路功能障碍（NLUTD）患者膀胱癌风险增加的文献存在争议，本研究旨在探讨监测性尿道膀胱镜检查在NLUTD患者中的价值。
在一项横断面研究中，对一所大学脊髓损伤（SCI）中心连续收治的129例（50例女性，79例男性，平均年龄51岁，范围18 - 88岁）患有NLUTD至少5年的患者进行了前瞻性研究，采用尿道膀胱镜检查和膀胱冲洗细胞学检查。
由于尿道膀胱镜检查和/或膀胱冲洗细胞学检查结果可疑，129例患者中有13例（10%）接受了经尿道膀胱病变切除术和/或随机膀胱活检。总体而言，在我们5%（7/129）的患者中发现了9项相关组织学结果：膀胱黑变病（n = 1）、肾源性腺瘤（n = 3）、角化性鳞状化生（n = 1）、肠化生（n = 3）和膀胱肌层浸润性腺癌（n = 1）。
通过监测性尿道膀胱镜检查，我们在5%患有NLUTD至少5年的患者中发现了相关组织学结果。因此，尽管理想的起始点和检查频率仍有待进一步前瞻性研究确定，但监测性尿道膀胱镜检查可能是必要的。
