Incidental findings of bladder lesions during radiological investigation
BAUS ePoster online library. Iskander M. Jun 25, 2019; 259477; P11-3 Disclosure(s): None to declare
Mr. Morkos Iskander
Mr. Morkos Iskander
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With increasing use of detailed cross-sectional imaging for investigation and staging of disease there is a rise in incidental findings the relevance of which is uncertain. Resulting investigations place additional demands on radiology and other specialties, cause anxiety to patients and escalate the cost to healthcare providers. The diagnostic accuracy of these 'incidentalomas' in the lower urinary tract is not well reported.


A search of all radiology requests and reports using the terms 'urology referral', 'urological referral', 'cystoscopy', 'cystoscopic', 'bladder mass, 'bladder tumour' and 'muscle invasive' was made for 2017. Case notes were reviewed for all identified patients. Those with prior history of urological malignancy, existing referral to urology, or requests made by urologists were excluded.


664 cases were identified and screened, with 36 eligible for inclusion. Out of 13 lesions on ultrasound four cases were confirmed to be bladder tumours (30.77%). Of 23 abnormalities on CT 10 were bladder tumours, 3 tumours in the lower ureter and one locally advanced prostate cancer (60.87%).

The diagnostic accuracy of malignancy in these incidental bladder lesions both on ultrasound (30.1%) and CT (60.9%) is higher than that of visible haematuria and as such further urgent investigation is warranted and should be prioritised in line with 2 week wait criteria.
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