Institute for the Medical Care of Civil Servants, São Paulo, Brazil.
Hospital do Servidor Público Estadual de São Paulo, Avenida Ibirapuera, 981, São Paulo, SP, 04029-000, Brazil.
World J Urol. 2021 Jun;39(6):1955-1960. doi: 10.1007/s00345-020-03389-4. Epub 2020 Jul 30.
The purpose of this study was to determine the prevalence of bladder lesions diagnosed during transurethral resection of the prostate (TURP), to identify the associated risk factors, and to correlate the macroscopic descriptions with the pathological findings.
This was a single-center retrospective case series conducted at a hospital in the city of São Paulo, Brazil. We reviewed the medical and surgical records of patients who underwent TURP between January 2012 and December 2017.
The final sample comprised 513 patients, with a mean age of 70.8 years. Bladder lesions were identified during TURP in 109 (21.2%) of the patients, and 90 of those lesions were submitted for pathological examination. The most common macroscopic finding was bullous edema, which was seen in 57 (63.3%) of the 90 lesions examined. The pathological analysis revealed chronic cystitis in 61 lesions (67.8%) and malignant lesions in 16 (17.8%). Of the 57 lesions described as bullous edema, 5 (8.8%) were found to be malignant.
Alterations in the bladder mucosa appear to be more common among elderly patients who use an indwelling urinary catheter for a prolonged period and among patients with recurrent urinary tract infections. In addition, the risk of a bladder lesion being malignant is apparently higher in current and former smokers than in never smokers. Our findings suggest that at-risk patients should undergo biopsy or resection of incidental bladder lesions even if those lesions seem to be benign, due to the low level of agreement between the visual analysis and the pathological examination.
本研究旨在确定经尿道前列腺切除术（TURP）中诊断出的膀胱病变的患病率，确定相关的危险因素，并将大体描述与病理发现相关联。
这是巴西圣保罗市一家医院进行的单中心回顾性病例系列研究。我们回顾了 2012 年 1 月至 2017 年 12 月期间接受 TURP 的患者的医疗和手术记录。
最终样本包括 513 名患者，平均年龄为 70.8 岁。在 109 名（21.2%）接受 TURP 的患者中发现了膀胱病变，其中 90 个病变进行了病理检查。最常见的大体发现是大疱性水肿，在检查的 90 个病变中，有 57 个（63.3%）存在大疱性水肿。病理分析显示 61 个病变（67.8%）为慢性膀胱炎，16 个（17.8%）为恶性病变。在描述为大疱性水肿的 57 个病变中，有 5 个（8.8%）为恶性病变。
在长期留置导尿管和反复尿路感染的老年患者以及当前和曾经吸烟者中，膀胱黏膜的改变似乎更为常见。此外，与从不吸烟者相比，当前吸烟者和曾经吸烟者的膀胱病变恶性风险明显更高。我们的研究结果表明，由于肉眼分析与病理检查之间的一致性较低，对于有风险的患者，即使那些病变似乎是良性的，也应进行活检或切除偶然发现的膀胱病变。
