I am a 35 year old female that has had blood in urine (hematuria) for about one year now. My physician sent off for a urinalysis (which was normal) and also sent it for Cytology with Fish test. Cytology and Fish test both came back positive for atypial cells and he kept mentioning some kind of chromosones. He then performed a CT renal protocol scan and a cystoscopy. On the cystoscopy, my uterus was bulging into my bladder so he could not get a great view of the bladder. He had previously noticed this on the CT before he came in to do the cystoscopy. Now the game plan is to wait three weeks and repeat the FISH and cytology to see if they come back positive and to get my gynecologist involved on the uterine bulge as he calls it. I see him in three weeks. He said he was very concerned about the two positives of atypia and wanted to repeat it first before discussing any further options with the exception of when I return in three weeks for the results, if they are positive, he will use anesthesia and take me to surgery to do biopsies of the bladder lining and go from there. Is this reasonable plan of action?
The cystoscopy would be the best next step, however, it was already attempted. Repeating the cytology may not really change the plan, especially if the bleeding is persistent. It may be better to find a way to perform the cystoscopy better. A discussion between the urologist and the gynecologist (or if you have access to a uro-gynecologist ), may represent a more logical next step.
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