title: The potential role of transrectal ultrasound as a tool for diagnosis or recurrence detection in bladder cancer. Two cases report.
abstract: OBJECTIVE
  To demonstrate the potential role of transrectal ultrasound (TRUS) as a tool for diagnosis or recurrence detection in bladder cancer.
  
  
  METHODS
  We report two cases of a primary lesion of bladder neck and trigone misdiagnosed by conventional sonographic abdominal evaluation and a case of bladder cancer recurrence diagnosed by TRUS performed before cystoscopy.
  
  
  RESULTS
  The first patient presented at the Emergency Room of our Hospital for a flank pain with concurrent haematuria. The abdominal ultrasonography showed a right hydronephrosis and a thickened bladder wall without endoluminal projections. The end-fire probe with a longitudinal approach clearly showed a thickening of the bladder wall extended from the bladder neck to the posterior area. The patient was submitted to a transrectal prostate biopsy and to a urethrocystoscopy with a transurethral resection. The second patient was admitted to the Urology Unit for haematuria. Abdominal ultrasonography was unremarkable and urine cytology negative. The TRUS with an end-fire probe showed a 5 mm area of irregular thickening of the mucosa at the bladder neck. The uretrocystoscopy confirmed the presence of a perimeatal papillary lesion.
  
  
  CONCLUSIONS
  We recommend the use of TRUS for bladder cancer detection in selected patients, as an easy, accurate and inexpensive tool. We need further study to validate the role of TRUS in the diagnosis and follow-up of bladder urothelial carcinoma.
authors.affiliation: Unit of Urology, Surgical Department, Macerata Hospital, Area Vasta 3, ASUR Marche, Italy. andreadoc1@libero.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Fabiani
authors.forename: Alessandra
authors.initials: A
authors.lastname: Filosa
authors.forename: Mara
authors.initials: M
authors.lastname: Piergallina
authors.forename: Lucilla
authors.initials: L
authors.lastname: Servi
authors.forename: Gabriele
authors.initials: G
authors.lastname: Mammana
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D012007:Rectum; D014463:Ultrasonography / Q000379:methods; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging*