Routine bladder biopsies in men with bladder outlet obstruction?
OBJECTIVE
To establish whether routine evaluation of light microscopic changes in bladder biopsies in men with graded bladder outlet obstruction correlates with urodynamic parameters and to evaluate the performance of two pathologists in bladder biopsy interpretation.


METHODS
In 63 consecutive patients presenting with lower urinary tract symptoms suggestive of bladder outlet obstruction, the workup included bladder biopsies, which were semiquantitatively and independently evaluated by two pathologists for fibrosis, elastosis, muscle cell degeneration, inflammation, and additional remarkable findings. Furthermore, as determined by their general impression, the pathologists gave a diagnosis of normal or graded abnormality. The pathologists' performance was compared and the clinical and urodynamic data were correlated to the consensus histologic diagnoses.


RESULTS
Fifty-four of 63 cases could be evaluated. The intraobserver and interobserver reproducibility were reasonable, with a kappa of 0.35 and 0.50, respectively. The consensus diagnosis of abnormal bladder biopsy correlated with impaired bladder compliance and capacity. However, no correlation was found between the presence and severity of histologic abnormalities and Schäfer class, urethral resistance factor, instability, postvoid residual urine volume, symptom score, and prostate volume.


CONCLUSIONS
Although abnormal bladder biopsies correlated significantly with impaired bladder capacity and compliance, routine evaluation of bladder biopsies is not indicated in the evaluation of bladder outlet obstruction.
Horn
Thomas
T
Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
Kortmann
Barbara B M
BB
Holm
Nina R
NR
Smedts
Frank
F
Nordling
Jørgen
J
Kiemeney
Lambertus A L M
LA
de la Rosette
Jean J M C H
JJ
D001706:Biopsy; D003955:Diagnostic Tests, Routine; D005355:Fibrosis; D006801:Humans; D006965:Hyperplasia; D006984:Hypertrophy; D008297:Male; D009130:Muscle, Smooth / Q000473:pathology; D032389:Myocytes, Smooth Muscle / Q000473:pathology; D015588:Observer Variation; D010338:Pathology, Clinical / Q000706:statistics & numerical data; D011379:Prognosis; D011470:Prostatic Hyperplasia / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D012372:ROC Curve; D015203:Reproducibility of Results; D001743:Urinary Bladder / Q000473:pathology*; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology; D014563:Urodynamics