Inconclusive urinary bladder biopsy; facts and lessons

ABSTRACT

To review the pathologic analysis of urinary bladder biopsies and study the frequency and causes of inconclusive biopsies among Iraqi patients. This is a retrospective study in which 933 patients underwent 1047 urinary bladder biopsy procedures during endoscopic evaluation, or transurethral resection of a known bladder cancer in Surgical Specialties Hospital, Baghdad, Iraq between June 2000 and June 2007. Pathologic records of patients were reviewed. In 933 patients aged 2-100 years with a mean age of 56.87 +/- 14.3 years who underwent 1047 urinary bladder biopsy procedures, pathologic review showed bladder cancer in 655 [62.56%] biopsies, no overt malignancy in 340 [32.47%] biopsies, no pathological diagnosis could be made in 43 [4.11%] biopsies, and nonnal biopsy in 9 [0.86%] biopsies. In 238 bladder cancer biopsies, pathologic analysis of muscle invasion was not carried out due to their lack of muscular tissue. Urinary bladder biopsy is one of the most common biopsies in urology practice. Every effort is made to prevent technical defects of taking and processing such biopsies, to optimize pathologic analysis and surgical management