title: Screening cystoscopy and biopsy in patients with neuropathic bladder and chronic suprapubic indwelling catheters: is it valid?
abstract: OBJECTIVE
  Screening for bladder malignancy in patients with neuropathic bladder and a chronic indwelling catheter by cystoscopy and biopsy is commonly performed. Despite this practice the test has not been fully validated to date. We analyzed our experience with this screening test and explored its validity when applied to our patients.
  
  
  METHODS
  We performed a retrospective analysis of screening biopsies in 36 patients with neuropathic bladder and a chronic indwelling catheter who had undergone yearly screening from 5 years after catheter insertion. Mean time since suprapubic catheter insertion was 12.1 years (range 8.7 to 23.8).
  
  
  RESULTS
  No tumors were ever identified in our screened group. However, histological findings were frequently abnormal, of which the most common are active chronic cystitis and squamous metaplasia.
  
  
  CONCLUSIONS
  Our study reinforces the increasing body of evidence suggesting that screening cystoscopy and biopsy in this group of patients is not valid. As a screening test, it fulfils few of the necessary criteria.
authors.affiliation: Spinal Injuries Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom.
authors.forename: R
authors.initials: R
authors.lastname: Hamid
authors.forename: J
authors.initials: J
authors.lastname: Bycroft
authors.forename: M
authors.initials: M
authors.lastname: Arya
authors.forename: P J R
authors.initials: PJ
authors.lastname: Shah
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D002408:Catheters, Indwelling / Q000009:adverse effects; D003558:Cystoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000209:etiology; D001750:Urinary Bladder, Neurogenic / Q000150:complications* / Q000628:therapy; D014546:Urinary Catheterization / Q000009:adverse effects