I had a cystoscopy in Nov. 2007 for microscopic hematuria. The cystoscopy found non-infectious inflammation. What is the risk of future bladder cancer? The cytology and FISH tests were normal at the time. I had no hematuria for 11 months. Now it recurred. Other than a recurrence of microscopic hematuria and occasional urgency, I have no other signs or symptoms. My urologist only has me returning in a year for follow-up. All he does is ask me questions about fluid and caffeine intake and does a urine dip. Should any other follow-up be done? I have had no renal ultrasound or IVP done. My only meds are vitamins, calcium, Allegra, Flonase, and Patanol.
Among patients who have hematuria, the chances of finding cancer are around 0.1 to 6.6%. What is more difficult to answer is what would constitute the best strategy for surveillance. There is no clear guide as to what to do, but is seems that annual testing with a urinalysis and creatinine is reasonable. Risk factors that can be modified would be important (reduction in smoking). Caffeine has not been clearly shown to be a risk factor (same goes for tea and artificial sweeteners). Stay positive.
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