Suprapubic (SP) transrectal (TR) and transvaginal (TV) echography in the diagnosis and staging of bladder carcinoma

Accuracy of suprapubic (SP), transrectal (TR), and transvaginal (TV) ultrasonography (US) in diagnosis and preoperative staging of bladder carcinoma is evaluated. From January 1990 to December 1992, 354 patients with gross haematuria, underwent bladder SP-US and cystoscopy and of this group 216 patients had transitional bladder cancer. Diagnostic sensitivity, specificity and accuracy for SP-US were, respectively, 73.5%, 88.5% and 63.8%. Clinical US and pathological staging were compared in 116 patients: downstaging was observed in 43.1% of the cases by SP-US and in 34.5% of the cases by TR-US or TV-US and overstaging in 6.9% of the cases by SP-US and in 15.4% of the cases by TR-US or TV-US. In this series accuracy of clinical staging by SP-US, TR-US, TV-US was inversely related to cancer stage and, conversely, clinical staging by pelvic CT scan accuracy is directly related to cancer stage.