1982 Volume 73 Issue 3 Pages 308-315
We have undertaken a comparative study of cystogram and histopathological findings of the patients with carcinoma of the urinary bladder (26 of them were treated with TUR (TUR group) and 20 were operated on for total cystectomy) after double contrast cystography by means of a universal gyroscopic X-ray TV apparatus. At the same time, preoperative transurethral echogram and histopathological findings were comparatively examined in 5 of the cases with total cystectomy.
We classified cystogram into six types according to the shape of mass: -0 (no abnormal shadow), A (papillary or narrow pedicle), B (broad pedicle), C (mountain-shaped), D (dish or bowl-shaped), and E (irregular relief). The alterations in the bladder wall at the base of the tumor masses were also investigated.
These studies showed that the masses of the total cystectomy group were larger in size than those of the TUR group and the shape of them was more frequently of C and D types. The larger alterrations in the wall were observed in the total cystectomy group. The higher the histopathological grading of malignancy, the greater the tendency for the shape of the masses to take C, D and E types.
In the group of total cystectomy, the higher the grade of invasion, the greater the tendency for the shape of the masses to take C and D types and alterations of the bladder wall were frequently visualized.
Transurethral echographic degree of invasion coincided with the histopathologic one in all cases but one, which revealed minimal invasion into lymphatics.
From the facts described above, we may conclude that more accurate preoperative diagnosis for carcinoma of the urinary bladder can be obtained by using double contrast cystography and transurethral echogram.
