Preoperative characteristics of squamous keratinizing metaplasia of the bladder in women

Introduction: The squamous keratinizing metaplasia (SCM) of the urine bladder. Also known as leukoplakia of the urine bladder, is a rare disease of the bladder, in which the normal transitional epithelium transforms to squamous epithelium above whom is found a layer of keratin. In most female patients there are typical non-specific urinary symptoms, i.e. symptoms of the lower urinary tract, such as frequency. Urgency. Suprapubic pain. Discomfort. As well as micro hematuria and less often macro hematuria.
Goal: The goal of the study is to determine the association of the preoperative characteristics of leukoplakia of the bladder in women, with the positive finding of leukoplakia on cystoscopy examination.
Materials and methods: In this study, we present a series of 5 patients with leukoplakia proven by cystoscopy and then preoperatively monitored according to a specific protocol. Before the cystoscopy, the severity of the patient’s symptoms was determined according to the international classification for urinary symptoms International Prostate Symptom Score (IPSS), a questionnaire who is used for urinary symptoms. Then laboratory analyses, ultrasonography of the urinary tract, cytological analysis of the urine, BTA (Bladder Tumor Antigen) immunohistochemical test, urine culture and cystoscopy were performed.
Results: In every female patient, the symptoms of the lower urinary tract and the pain were the most common symptoms. All patients had high initial IPSS score. Urine culture was positive in three patients, cytological analysis varied between the first and second classification groups, ultrasonography showed thickened bladder walls in 3 patients, BTA (bladder tumor antigen) immunohistochemical tests were negative in all patients, on cystoscopy in all patients were diagnosed with a “leukoplakia like” change in the trigonum of the bladder.
Conclusion: The bipolar transurethral resection. It will relieved the symptoms in women with squamous keratinizing metaplasia, will improve the quality of life, and will be superior in relationship to the conservative treatment.