found microscopic hematuria +1 on routine check up.. 49 yr male, never smoked. never worked with chemicals or carcinogens. CT with and without contrast. only found BPH. psa neg. cystoscopy found area of inflammation described as a red spot. nothing else found. biopsy and cytology was done. waiting on results. recently started excersing hard ie running and weights. my question is what are the chances this could be PRIMARY carcinoma in situ (cis). doc said" looked like a bruise". "area of inflammation" Q1- how often do you see red spots with cystoscopy and what percentage of red spots that you see on cytoscopy's performed that turn out to be PRIMARY CIS. Please don't sugar coat. give it to me straight. q2-can you get a bladder spot/bruise from excersise . Q3- what else (if not cis) could cause this.
I can understand your concern for carcinoma in situ (cis ) bladder.
First of all, your age goes against the typical age of CIS bladder or bladder cancer. The median age at diagnosis is 68 and bladder cancer is less likely to be present in males less than 55 years. Moreover the CT scab has come out normal. Although the best investigation for bladder cancer is cystoscopy and biopsy, yet CT is also quite informative. Your biopsy report is still to come and the presence of red patch on cystoscopy does not label it as CIS bladder.
There is no exact figure of the red spots on cystoscopy that turn out to be CIS but red patches can be often seen on cystoscopy. In one study which has been reported, out of the total of 193 (17.7% of total biopsies) red patch biopsies, malignancy was found in 23 (11.9%) and 18 of 23 (78.3%) were CIS. No malignancies were detected in red patches from patients under the age of 60 years. Although it may alarm you about CIS but it should be stressed that the presence of red patch on cystoscopy does not warrant it to be CIS.
Haematuria or blood in urine which can be gross or microscopic can be caused by just overdoing your normal exercise routine. 'Joggers haematuria' results from repeated jarring of the bladder during long-distance running or even just normal running and jogging. Hence strenous exercise can cause repeated damage to kidneys or bladder. This answers your second query.
Usually CIS is seen as a red velvety patch on cystoscopy but hemorrhagic cystitis may also present as red inflammatory area seen on cystoscopy. It results from damage to the bladder's transitional epithelium and blood vessels by toxins, pathogens, radiation, drugs, or disease. Whether this is causing the red spot in bladder in your case or not will be clear only after the biopsy report.
Hope that this information helps and hope that you get better soon.
just wanted to let you know i was mistaken. the urologist did a urine cytology not an actual biopsy at my cytoscopy. the report just came back suspicious of a low grade papillary cancer. said pappilary fragments found? :(. he wants to bring me to the operating room to burn it off and get a tissue sample. he said the odds of it being cancer are 50%. he said the red lesion was NOT velvety in appearance but says if it is cancer it could be the more sinister form of CIS. i thought that CIS was high grade. the report said suspicious of low grade? but i had no visible pappillary lesions. anyway now i am at an all time distress. not sure how accurate cytology is.
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