Efficacy of Urine Cytology in the Diagnosis of Bladder Cancer in Aminu Kano Teaching Hospital: Comparism of Cytology and Histological Findings.

Abstract

Background: Bladder cancer is a common urologic malignancy worldwide and second most common
genitourinary malignancy after prostate cancer. Diagnosis of bladder cancer in developing countries is challenging. Despite the varying results in detection rate of bladder cancer by using the urine cytology, the method can be used in developing countries such as Nigeria, where there are limited diagnostic facilities. Objective: The general objective of the study was to determine the efficacy of urine cytology in the diagnosis of bladder cancer, in Aminu Kano Teaching Hospital. The specific objectives were; to determine the sensitivity, specificity and accuracy of urine cytology in the diagnosis of bladder cancer in Aminu Kano Teaching Hospital. Methodology: It was a prospective descriptive study of 52 patients who consecutively presented with suspected bladder cancer and were recruited via the Urology outpatient unit and casualty unit of Aminu Kano teaching hospital over a period of one year. On presentation patients with emergencies were resuscitated and evaluated clinically to establish the diagnosis of bladder cancer. Patient who had met the inclusion criteria and consented to the study had urinalysis and urine microscopy culture and sensitivity, abdominopelvic ultrasound scan, electrolyte urea and creatinine and full blood count. All the patients subsequently had fresh voided or catheter urine sample taken immediately for cytological analysis. Cystoscopy was done in the urology theatre under local anaesthesia in most patients with exception of few who had general anaesthesia. The cystoscopic findings were noted and multiple biopsies were taken and sent for histological analysis. Results: Of the Fifty two patients reviewed, the mean age was 55.6± 16.3 with male to female ratio of M: F 4.2:1. The overall Sensitivity, Specificity and Accuracy of Urine cytology were 60.4%, 100% and 63.5% respectively. The False negative rate was 39%. Urine cytology was found to be effective in detecting bladder cancer, p<0.05). Conclusion: Based on the findings from this study, Urine cytology is an effective method for evaluation of patients presenting with features suggestive of bladder cancer. Routine use of urine cytology as the initial test for evaluating patient with suspected bladder cancer is recommended.