Introduction: The lesions of urinary bladder both non-neoplastic and neoplastic pose a common source of both morbidity and mortality. An accurate diagnosis of these lesions requires cystoscopy which allows a direct visualization of the bladder mucosa and biopsies of suspected lesions. Urinary bladder cancer is sixth most common cancer worldwide and represents a heterogeneous group of neoplasms. The current study aimed to study the different bladder lesions and its clinical features to detect it in early stage and as a mainstay option in the diagnosis and follow up.  Materials and methods: This was a retrospective analysis of biopsies of urinary bladder submitted to the department of pathology over a period of 12 months. The study was approved by the institutional review board of the Universal College of Medical Sciences (UCMS-TH). All the urinary bladder biopsies received in the department were included in the study whereas autolysis of specimen and inadequate biopsies were excluded.  Results: Among the 36 cases of urinary bladder lesions, the majority (35.36%) were in age group 61-70 years (22.33%). The patients had combination of lower urinary tract symptoms, the commonest being hematuria. 30.55%  had non-neoplastic lesions and 69.55% had neoplastic lesion. Among non- neoplastic cases, 5.55% had chronic granulomatous inflammation. Most common neoplastic lesions was infiltrating urothelial carcinoma (n=6) followed by non- invasive urothelial neoplasia (n=5).  Conclusion: A variety of lesions occur in urinary bladder and is commonly encountered by pathologist. Hematuria was commonest symptom and the clinicians investigated these patients further, which led to discovery of the urothelial tumors. Identification of these patients has an important impact on prognosis as well as on therapeutic approach.

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INTRODUCTION The lower gastrointestinal bleeding (LGIB) is an alarming symptom and common disease with annual admission of 0.15% with mortality rate of 5-10%. LGIB is caused by neoplastic and non-neoplastic lesions. For accurate diagnosis of various colorectal lesions, colonoscopy is gold standard, convenient and cost effective procedure. It is the investigation of choice in LGIB and helps in early diagnosis of colorectal carcinoma. This study was aimed to scrutinize the clinical and colonoscopic findings in patients with LGIB in UCMS.   MATERIAL AND METHODS This was a hospital based prospective observational study conducted after taking permission from institutional review committee in January 2017 at UCMS-TH from 15th January 2017 to 15th January 2018. All patients presenting with LGIB who fulfilled inclusion and exclusion criteria and gave written consent were included.   RESULTS Total 88 patients were included in the study. The mean age of our patients was 48 ±17 years with age range from 17-81 years. Majority were in the age group 50-60 years (25%) (n=22). Colonoscopy detected abnormality in 73.8% cases. The common non-neoplastic were haemorrhoids and non-specific colitis (14.5% each) followed by 12.5% of neoplastic cases. The higher frequency of colorectal lesions was observed in males comprising 72.7% (n=64) patients. The most commonly diagnosed etiologies of LGIB were haemorrhoid and nonspecific colitis respectively.   CONCLUSION Colonoscopy detected abnormality in 75% of cases. The common causes of LGIB were haemorrhoids and non-specific colitis followed by neoplastic lesion. A careful history, physical and colonoscopic examination with or without biopsy makes significant impact for early diagnosis and treatment.

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