Value of Cystoscopy in Cervix Cancer Staging - Analysis of 1,049 Cases -

Moon, Woo Chul; Kim, Young Kyoon

Abstract

Cystoscopy is important in staging of cervix cancer. However, there have been controversies about its routine use, interpretation of the result and necessity of biopsy during cystoscopy. Herein we analysed 1,049 cases. Among 1,049, 53 abnormalities (5.1 %) were found.; 22 grossly visible tumor invasion (2.1 %), 30 bullous edema (2.9 %), 1 transitional cell carcinoma (0.1 %). Transurethral biopsy was done on 14 cases with gross tumor invasion and 13 (92.9 %) showed microscopic bladder mucosa invasion, all of which were in from stage II b to IV. Bullous edema was analyzed by biopsy results, operative findings and computed tomography scan in 25 cases.; 13 bladder muscle invasion (52 %), 2 bladder mucosa invasion (8%), 5 normal bladder wall (20 %), 5 nonspecific inflammation (20 %). However, cystoscopic biopsy was unreliable in evaluation of bullous edema. Biopsy confirmed bladder mucosa invasion were found in 15 of 1,049 (1.4 %).; stage 0 to II a 0. stage II b 2.4%, III 11.3%, IV 15%. We conclude that cystoscopy is useful only in stage more than II b, bullous edema means bladder wall invasion in majority of cases and should be evaluated by noninvasive computed tomography and that biopsy should be reserved only in suspicious cases.