Preoperative diagnosis of urinary bladder involvement in adenocarcinoma of colon and rectum

Abstract

Objective: Objective of the study was to compare urinary symptoms, urinalysis, computed tomography, intravenous pyelography, ultrasonography between colorectal adenocarcinoma with urinary bladder involvement and without urinary bladder involvement.

Material and method: Patients with adenocarcinoma of the colon and rectum who had the first operation between January 1999 and October 2004 were included in the present study. All patients were divided into the bladder adhesion group and nonadhesion group. Sex, sites of tumor, urinary symptoms and preoperative investigations were compared.

Results: 453 patients were included in the present study with 264 males and 189 females (sex ratio M:F = 1.4:1). 26 cases (5.7%) had bladder adhesion. Males had more chance of having bladder involvement. Sigmoid and rectum were the most common sites of bladder adhesion. All cases with urinary symptoms had bladder involvement. Urinalysis and computed tomography had a sensitivity of 59% and 61%, respectively. All cases whose computed tomography showed bladder involvement had bladder adhesion during surgery. Cystoscopy had a sensitivity of 75%. Ultrasonography and IVP did not help in detection of bladder invasion.

Conclusion: History of urinary symptoms, urinalysis, computed tomography should be routinely performed in patients with adenocarcinoma of the sigmoid and rectum to detect urinary bladder involvement and to inform modes of urinary tract diversion to patients before surgery.