Relation of cystoscopy findings and pathologic characteristics of bladder Tumors at St. Paul hospital Millennium Medical college, from 2020 to 2024, cross sectional study

Abstract

Abstract Introduction: Urinary bladder lesions, non-neoplastic and neoplastic, are collectively responsible for significant morbidity and mortality throughout the world. Cystoscopy is the primary diagnostic tool for patients who are suspected of having bladder tumors and an accurate diagnosis of urinary bladder lesions requires simultaneous data from urology, radiology and surgical pathology labs. Currently, there is a gap in understanding how specific cystoscopy features relate with histopathological findings. Objective: To determine the association between cystoscopy findings and pathologic characteristic of bladder lesions, at St. Paul Hospital Millennium Medical College from August 2020 - August 2024 G.C. Methods: Cross sectional study was conducted and all cystoscopy biopsy samples from August 2020 to August 2024 G.C was included. Data was collected from the anatomic pathology record file and cystoscopy reports by using structured, self-prepared check list. Data was entered and analysed using SPSS version 27. Minimum sample size was calculated to be 384. All samples fulfilling the eligibility criteria was included. Descriptive analysis was used for sociodemographic data, cystoscopic findings and histologic spectrum; association direction and magnitude of association was calculated using logistic regression analysis version 27. Result – In this study Invasive high grade urothelial carcinoma (IHGUC) was the commonest diagnosis made on biopsy accounting for 37% of bladder tumors. 77% of cases where invasive tumors and 58.5% were low grade tumors. A significant association was found between cystoscopic findings, such as solid configuration, right wall, posterior wall, and anterior wall location, and tumor invasion into the lamina propria. Additionally, solid configuration, left lateral wall location, and 4 | Page the largest lesion size were significantly associated with muscle invasion. Furthermore, solid and papillary configurations, right wall location, and lesion size showed a significant relationship with tumor grade. Conclusion - This study showed IHGUC to be the commonest diagnosis in cystoscopic biopsies of bladder tumors followed by ILGUC, among the noninvasive tumors NIPCLG was the commonest. Furthermore, this study highlighted a statistically significant relationship between cystoscopic findings and histopathologic characteristics, revealing a strong association between the lesion's configuration, location, and size with both the tumor's invasiveness and its grade. Key words – Cystoscopy, biopsy, bladder tumor, association