How is carcinoma in situ (CIS) bladder cancer diagnosed?

Updated: Feb 23, 2021
  • Author: Kara N Babaian, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

CIS is often misdiagnosed as a bladder infection and treated as such. Patients with irritative voiding symptoms that do not resolve with treatment for UTI require further evaluation. The investigation should include urine cultures for fungi and tuberculosis, as well as cytology studies.

The first step in a bladder cancer workup involves the patient undergoing cystoscopy in an office setting. Cystoscopy in patients with CIS may reveal a characteristic red, velvety appearance that resembles an area of inflammation. In some cases, however, CIS is not visible on gross inspection. If there is a suspicious area or visible tumor a biopsy or resection should be done during repeat cystoscopy performed in the operating room.  [64]


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