Benign Glandular Lesions of Urinary Bladder: Diagnostic Dilemma and Clinical Significance
Published: November 1, 2019 | DOI: https://doi.org/10.7860/JCDR/2019/40723.13290
Prasad Mylarappa, Sandeep Puvvada, D Ramesh
1. Professor, Department of Urology, M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India.
2. Assistant Professor, Department of Urology, M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India.
3. Professor, Department of Urology, M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India.
Correspondence
Dr. Prasad Mylarappa,
M.S. Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India.
E-mail: prasadmyluro2@gmail.com
Introduction: Different types of glandular lesions are seen in the urinary bladder which pose a significant diagnostic dilemma.
Aim: To report modalities of diagnosis, management and follow-up of patients with glandular lesions of the bladder.
Materials and Methods: This was a retro-prospective study of 16 consecutive patients of urinary bladder glandular lesions. The data were obtained from hospital records. These patients underwent urine cytology, ultrasonography and contrast-enhanced computed tomography. All patients underwent cystoscopy with biopsy of the lesion or Transurethral Resection of Bladder Tumour (TURBT) and were followed-up for 6-34 months after surgery.
Results: There were 11 females (68.7%) and the median age was 34 (17-48) years. The most common symptom was dysuria, frequency, and nocturia. The most common site of tumour was at the trigone (68.8%) followed by lateral wall (25%) and dome (6.3%). The commonest macroscopic appearance was a papillary lesion (68.8%) followed by polypoidal (18.7%) and flat lesions (12.5%). Fourteen patients underwent TURBT (87.5%) and two patients underwent bladder biopsy (12.5%). Two patients (14.3%) with TURBT developed recurrence of tumour after 1.5 and 2 years, while one of the patient with bladder biopsy developed recurrence of the lesion after nine months. The most common histopathological finding was a combination of cystitis cystica with cystitis glandularis (31.3%).
Conclusion: Results suggest that a combination of various investigation modalities and a high index of suspicion is required in establishing the diagnosis. The accurate diagnosis could be established after histopathological examination of the resected specimen or bladder biopsy.
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