Annual Endoscopy and Urine Cytology for the Surveillance of Bladder Tumors After Enterocystoplasty for Congenital Bladder Anomalies

Higuchi, Ty; Fox, Janelle; Husmann, Douglas A.

doi:10.1016/j.juro.2011.07.028

Cited by 61 publications

(31 citation statements)

References 20 publications

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“…Thus, for Higuchi et al, the data strongly suggest that surveillance cystoscopy did not meet all the criteria needed for a successful screening protocol (Incidence should be clearly defined and frequent enough to make follow‐up financially reasonable, the cancer must have a high prevalence at low stage and the screening test should have a high specificity and sensitivity). Similarly, Kokorowski et al concluded that annual cystoscopy and cytology were unlikely to be cost effective after augmentation cystoplasty.…”

Section: Methodsmentioning

confidence: 99%

Risk of malignancy after augmentation cystoplasty: A systematic review

Biardeau

Chartier‐Kastler

Rouprêt

et al. 2015

Neurourology and Urodynamics

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Section: Methodsmentioning

confidence: 99%

Risk of malignancy after augmentation cystoplasty: A systematic review

Biardeau

Chartier‐Kastler

Rouprêt

et al. 2015

Neurourology and Urodynamics

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“…A decision analysis performed by Kokorowski et al determined that annual screening cystoscopy and cytology were not cost-effective (80). Higuchi et al have recommended cystoscopy in patients with four or more symptomatic UTIs per year, gross hematuria, microscopic hematuria with 50 or more RBC/hpf, abnormal radiographic screening studies, chronic perineal, pelvic or bladder pain, and for patients with colonic augments age 50 or older (consistent with colonoscopy recommendations) (79,81). Any significant change in a patient's baseline function may merit investigation with anatomic or functional studies for this vulnerable population at the clinical discretion of the Urologist.…”

Section: Malignancymentioning

confidence: 96%

“…However, others argue that yearly endoscopy is not cost effective and the potential morbidity makes it an ineffective screening procedure (78,79). A decision analysis performed by Kokorowski et al determined that annual screening cystoscopy and cytology were not cost-effective (80).…”

Section: Malignancymentioning

confidence: 99%

Long-Term Sequela of Pediatric Bladder Reconstruction

Roth

Keenan

Cain

et al. 2015

Curr Bladder Dysfunct Rep

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Children with refractory neurogenic bladder (NGB) who have failed maximal medical management are presented with options for bladder reconstruction. It is critical to understand the long-term sequela of bladder augmentation and bladder neck reconstruction to properly counsel families regarding these procedures. Benefits may include preservation of renal function, continence, reduced risk of renal-related mortality and potential improvements in quality of life (QOL). However, these advantages must be balanced with the risks of bladder calculi, perforation, need for additional surgery, acid/base disturbances, vitamin B12 deficiency and malignancy. Therefore, careful patient selection and preoperative counseling are paramount for those undergoing bladder reconstruction which includes intestinal bladder augmentation, as these patients require lifelong vigilant follow-up. IntroductionChildren with neurogenic bladders (NGB) are initially managed with clean intermittent catheterization (CIC) and anticholinergic medications in order to maintain a sizable, continent, and compliant urinary reservoir. Despite early and aggressive intervention, some patients undergo lower urinary tract reconstruction (bladder augmentation, catheterizable channel and/or bladder neck reconstruction) to protect their upper tracts and achieve continence. In a few select patients with favorable urodynamics (UDS) and low outlet resistance, a bladder neck procedure (BNP) can be performed without bladder augmentation to achieve continence. Myelodysplasia, specifically spina bifida (SB), remains the most common etiology of NGB in the pediatric population. Due to medical advances, particularly in the realm of Urology, more SB patients with bladder reconstruction are surviving into adulthood. We review current literature regarding long-term sequela of bladder reconstruction in pediatric patients with neurogenic bladder, with a primary focus on bladder augmentations for refractory NGB secondary to SB.

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“…The subset of these patients with renal transplantation receiving immunosuppression or with a history of viral cystitis are at an even greater risk for the development of bladder cancer [67]. Though others have previously advocated for screening 10 years after augmentation surgery, current screening methods for bladder cancer in this population are neither sensitive nor specific [68,69]. Often, patients who develop bladder cancer have normal cystoscopy within 1 year of diagnosis.…”

Section: Bladder Cancer Risk and Surveillancementioning

confidence: 99%

Emerging Concepts in Transitional Care of Congenital Genitourinary Reconstructions

Loftus

Wood

2015

Curr Bladder Dysfunct Rep

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Patients with congenital urogenital abnormalities represent a unique population with health care needs that often exceed the average urologic patient. Congenital uropathic patients, especially those with prior genitourinary reconstructions, display a range of bladder management strategies which must be meticulously managed by their urologist. The time encompassing the transition of care from the pediatric to the adult setting is a critical milestone that if left uncoordinated may result in the interruption of care and missed opportunities for disease prevention. During transition, the adult urologist should carefully assess the patient's voiding habits, renal function and bladder function as well as new or worsening complaints. These complex patients require careful lifelong surveillance for evidence of almost inevitable changes in urinary function.

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Annual Endoscopy and Urine Cytology for the Surveillance of Bladder Tumors After Enterocystoplasty for Congenital Bladder Anomalies

Abstract: Due to the low incidence of malignancy, lack of proven benefit and enhanced cost containment we recommend that annual surveillance endoscopy and cytology be discontinued.

Cited by 61 publications

References 20 publications

Risk of malignancy after augmentation cystoplasty: A systematic review

Risk of malignancy after augmentation cystoplasty: A systematic review

Long-Term Sequela of Pediatric Bladder Reconstruction

Emerging Concepts in Transitional Care of Congenital Genitourinary Reconstructions

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