Benign Glandular Lesions of Urinary Bladder: Diagnostic Dilemma and Clinical Significance

Abstract

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 followup 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.

Keywords

• cystitis cystica
• cystitis glandularis
• intestinal metaplasia
• transurethral resection of bladder tumour