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Ideopathic microscopic hematuria, urinary bladder polyps, surgery necessary?

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Practicing since : 1998
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I have had ideopathic microscopic hematuria for at least 15 years. Since I used to be a smoker, my urologist requires me to come in for a full work-up every other year. (Ultrasound of kidneys, urine cytology, FISH test and cystoscopy.) When I went for my two year work-up in May of this year, during my cystoscopy, my doctor showed me a bladder stone and also, a group of bladder polyps. She informed me that it used to be believed that bladder polyps lead to bladder cancer, but that this theory had been disproven. Thus, she told me that I needed to do absolutely nothing with the polyps and to just leave them there. She told me that my work-up was completely negative and that my FISH test came back with excellent results. As I read on the internet (which I KNOW that I should not do, due to erroneous information on it), I find that most websites say that bladder polyps need to be removed. When I called my doctor's office about this and talked with the nurse, she told me (and sounded frustrated about I didn't believe her or the doctor) that the polyps are nothing like colon polyps and are no big deal....that they are incidental findings during cystoscopies. She also stated that as of the past few years, not removing them has become the universal standard. I am happy not to do anything, but if the information I've been given is inaccurate and I need to get these polyps taken out, I want to do it as soon as possible. Can urologists really tell if polyps are benign through a cystoscopy? Could you please help me with some clarification on this issue? Thanks so much! XXXXXXX
Posted Mon, 16 Apr 2012 in Urinary and Bladder Problems
Answered by Dr. Rajiv goel 6 hours later
Thanks for the query.

The polyps seen on cytsoscopy can be edema due the inflammation caused by the bladder stone and one can tell on inspection itself that it is nothing but edema and nothing needs to be done.

However, beyond that, every polyp in bladder needs to be biopsied and sent for histopathology.

A polyp can be cancerous until proved otherwise.So it is advisable to send it for biopsy.

Hope i have answered your query.I will be available for follow up.
Above answer was peer-reviewed by
Follow-up: Ideopathic microscopic hematuria, urinary bladder polyps, surgery necessary? 9 hours later

Thank you for your quick response. I have a few more quetions. Do polyps in bladders grow slowly over time and turn into cancer like they do in the colon? Is it a good sign that my cytology and FISH test were both negative with regards to these polyps? I plan on making an appointment with another urologist to get a second opinion and to request that my polyps be removed. Is it normal for them to grow in a group and is that an ominous sign? Finally, can you explain the process of bladder stones causing edema that results in polyps? Do they go away after the imflammation is gone? Thank you for your help!

Thanks so much!
Answered by Dr. Rajiv goel 4 hours later

Polyps in bladder dont change into cancer; either they are simple polyp or they are cancer growths. The polyps in bladder don't behave like polyps in colon.

The final diagnosis can be reached only by histopathology.

It is very good that your cytology and FISH are negative. It suggests that you don't have high grade lesion at least.

Polyps due to edema usually disappear in 2-3 weeks after inflammation is gone. Polyps secondary to inflammation are nothing but swollen normal tissues.

Hope this answers your query. Should you have more concerns, I will be available for follow ups.

Above answer was peer-reviewed by
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