Manejo del paciente con cistoscopia normal pero con marcadores o citología sospechosa

Bladder cancer is usually assessed by examination of tissue taken from the bladder, either by surgery or by biopsy; however, trace elements in the urine, known as biomarkers, can also provide an assessment. The challenge arises when the two methods do not agree: the tissue sample is positive for cancer, but the biomarker is negative, or the reverse. Urinary cytology still represents an essential complement in the follow-up of the TVNMI. Patient with positive cytology during their follow-up should be carefully evaluated with cystoscopy and multiple random bladder biopsies. In the future, a high negative predictive value of urine biomarkers could be used in patients who do not require follow-up by cystoscopy. By the way, urinary biomarkers require further developments, in order to accept their use without requiring them to be associated with another usual diagnostic test.