Bladder Cancer Diagnosis and Detection: Current Status

The cornerstones in the detection of urinary bladder cancer is the combination of urinary cytology and urethrocystoscopy (UCS). Limitations concerning these tests are a low sensitivity of cytology and a problem in detection of small papillary lesions and flat carcinoma in situ (CIS) with standard UCS. These limitations have led to newer techniques, like photodynamic diagnosis (PDD) and narrow band imaging (NBI) to improve the visibility by UCS. Once a bladder tumor has been detected it should be resected by transurethral resection (TURBT) to obtain adequate tissue for pathological assessment. PDD-assisted resection is a promising technique with better tumor detection, more complete resection and a better recurrence free survival. Imaging techniques like CT and (enhanced-)MRI play an important role in accurate staging of UBC and in the detection of recurrences of MIBC during follow-up.