A 60 year old smoker male patient presents with painless gross hematuria for 1 day. IVU shows 1.2 cm filling defect at the lower pole of infundibulum. Which is the next best investigation to be done?
- 60yr old smoker, hx. of PAINLESS gross hematuria - are findings of CA BLADDER - First investigation to be done is Cystoscopy. Once tumor visualized in cystoscopy, Biopsy done to confirm diagnosis. Urine cytology is done usually for UTI not for Bladder Cancer. A DMSA renal scan is a diagnostic imaging that evaluates the function, size, shape and position of the kidneys and detects scarring caused by frequent infections. BLADDER CANCER: Investigations- IOC for Dx- Cystoscopy + Biopsy- Urinary cytology* To confirm the diagnosis* But location of tumor cannot be identified.- IOC for staging- MRI - Urinary tumor markers* BTA (Bladder tumor antigen)* NMP -22 (Nuclear Matrix Protein)* Lewis- X- antigen* Hyaluronidase* Helpful in diagnosis and for follow up to assist the response of therapy and todetect recurrence
Cystoscopy
Urine cytology
USG abdomen
DMSA scan
Urinary bladder