OBJECTIVE: The National Institute of Clinical Excellence (NICE) published guidelines in 2010 recommending the use of cystoscopy to investigate profound lower urinary tract symptoms (pLUTS), recurrent urinary tract infection (rUTI) and pain in men. Currently, there are no equivalent guidelines for women. We aimed to examine the diagnostic performance of flexible cystoscopy (FC) when it is used in this context in both men and women.
METHODS: Results of all outpatient FCs undertaken in our department between April 2009 and March 2010 were examined retrospectively. Patients undergoing FC for the investigation of pLUTS, rUTI or pain were included. Diagnostic performance was calculated which was defined as the number of patients diagnosed with a clinically relevant abnormality at FC divided by the total number of patients undergoing FC for this indication.
RESULTS: Of the 1809 patients who underwent FC during the study period, 113 underwent FC to investigate pLUTS, rUTI or pain. Diagnostic performance was 11.5% (n=13), being 11.4%, 19.2%, and 0% in those with pLUTS, rUTI and pain respectively. Bladder cancer was diagnosed in 1 patient (0.9%) who underwent FC to investigate pLUTS but also had non-visible haematuria. Urethral stricture was diagnosed in 9 cases (8.0%) and intravesical calculi in 4 cases (3.5%).
CONCLUSION: Clinically relevant abnormalities were found in 11.5% of patients with pLUTS, rUTI or pain supporting recently published NICE guidelines recommending cystoscopy in patients with pLUTS or rUTI. Of the 17 patients investigated for pain, none were found to have clinically relevant abnormalities; further studies are required to define the clinical utility of FC in these cases.
Written by:
Howles S, Tempest H, Doolub G, Bryant RJ, Hamdy FC, Noble JG, Larre S Are you the author?
Nuffield Department of Surgical Sciences, Department of Urology, Churchill Hospital, Oxford, United Kingdom, OX3 7LJ, 07881953925;
Reference: J Endourol. 2012 May 21
doi: 10.1089/end.2012.0139
PubMed Abstract
PMID: 22612791