title: Do We Need Surveillance Urethro-Cystoscopy in Patients with Neurogenic Lower Urinary Tract Dysfunction?
abstract: OBJECTIVE
  To examine the value of surveillance urethro-cystoscopy in patients with neurogenic lower urinary tract dysfunction (NLUTD) in regard to the conflicting literature as it is generally agreed that patients with NLUTD are at increased risk for bladder cancer.
  
  
  METHODS
  In a cross-sectional study, a consecutive series of 129 patients (50 females, 79 males, mean age 51, range 18-88) suffering from NLUTD for at least 5 years was prospectively investigated using urethro-cystoscopy and bladder washing cytology at a single university spinal cord injury (SCI) center.
  
  
  RESULTS
  Due to suspicious urethro-cystoscopy and/or bladder washing cytology findings, 13 (10%) of 129 patients underwent transurethral resection of the bladder lesion and/or random bladder biopsies. Overall, 9 relevant histological findings were found in 5% (7/129) of our patients: bladder melanosis (n = 1), nephrogenic adenoma (n = 3), keratinizing squamous metaplasia (n = 1), intestinal metaplasia (n = 3), and muscle-invasive adenocarcinoma of the bladder (n = 1).
  
  
  CONCLUSIONS
  Using surveillance urethro-cystoscopy, we found relevant histological findings in 5% of our patients suffering from NLUTD for at least 5 years. Thus, surveillance urethro-cystoscopy might be warranted, although the ideal starting point and frequency remain to be determined in further prospective studies.
authors.affiliation: Neuro-Urology, Spinal Cord Injury Center and Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland.
authors.forename: Ulla
authors.initials: U
authors.lastname: Sammer
authors.affiliation: Neuro-Urology, Spinal Cord Injury Center and Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Walter
authors.affiliation: Neuro-Urology, Spinal Cord Injury Center and Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland.
authors.forename: Stephanie C
authors.initials: SC
authors.lastname: Knüpfer
authors.affiliation: Neuro-Urology, Spinal Cord Injury Center and Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Mehnert
authors.affiliation: Institute of Surgical Pathology, University of Zürich, University Hospital Zürich, Zürich, Switzerland.
authors.forename: Beata
authors.initials: B
authors.lastname: Bode-Lesniewska
authors.affiliation: Neuro-Urology, Spinal Cord Injury Center and Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003558:Cystoscopy; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000453:epidemiology / Q000209:etiology; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D014570:Urologic Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult