Published 2016-03-23
ferdi ardiansyah H R Danarto


Objective: We evaluated the value of urinary cytology, and presence of hydronephrosis to predict muscle invasive bladder cancer. Material & methods: We retrospectively analyzed data of 167 patients that diagnosed bladder cancer from medical record at Sardjito General Hospital Yogyakarta, between 2004-2011. Preoperative parameters were evaluated including age, gender, number and location of bladder cancer, urinary cytology, as well as presence of hydronephrosis. The outcome was muscle invasive bladder cancer. Results: A total of 96 (57.5%) patients had positive urinary cytology, 80 (47.9%) had hydronephrosis, most location of tumor were in trigone 43 (25.7%). The youngest patient was 26 years and the oldest was 84 years old, male was most affected in 145 (86.8%). On bivariate analysis, positive urinary cytology and hydronephrosis were associated with muscle invasive bladder cancer (OR 0.08 CI 0.038–0.167; OR 30.24 CI 12.72–71.89, respectively, each p < 0.05). Combination urinary cytology and hydronephrosis incrementally improved prediction of muscle invasive bladder cancer with positive and negative predictive value were 93.9% and 71.4%, respectively. Presence of hydronephrosis was associated with tumor location in trigone (p < 0.05). Conclusion: Urinary cytology and hydronephrosis were associated with muscle invasive bladder cancer, and can be used to predict muscle invasive bladder cancer.



Urinary cytology, hydronephrosis, muscle invasive bladder cancer


David P, Wood. Urothelial tumour of the bladder, in Campbell-Walsh Urology. 10th ed. Saunders: Philadelphia USA. p. 2311.

Stenzl, Witjes. Guideline on bladder cancer muscle-invasive and metastatic. EAU; 2012.

John P, Gary L. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. Los Angeles. Journal of Clinical Oncology. 2001; 19(3): 666-75.

Rene, Cury. Conservative treatment of invasive bladder cancer. Montreal: Current Oncology. 2009; 16(4).

Stephen J, William A. Non–Muscle-Invasive Bladder Cancer (Ta, T1, and CIS), in Campbell-Walsh Urology. 10th ed. Saunders: Philadelphia USA. p. 2381.

Jimie M, Shahrokh F. Urinary cytology has a poor performance for predicting invasive or high-grade upper-tract urothelial carcinoma. Dallas: BJU Int. 2011; 108: 701-5.

James C, Shahrokh. Preoperative hydronephrosis, ureteroscopic biopsy grade and urinary cytology can improve prediction of advanced upper tract urothelial carcinoma; 2010.

Evelyne C, Jean J. Bladder cancer in practical urology essential principle. Springer: London; 2011. p. 512.

Parag G. Impact of age and gender on the clinicopathological characteristics of bladder cancer. India: Department of Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences; 2009.

Donald G. Cancer of the bladder in adult and pediatric urology. 4th ed. Virginia: William and Wilkins; 2002. p. 2255.

Nandakishore S. Predicting the risk of high-grade bladder cancer using noninvasive data. Karger, Jurusalem. Urol Int. 2011; 87: 319–24.

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Department of Urology, Faculty of Medicine/Airlangga University