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Lynch syndrome, uterine and colon cancer, UTI. Cytoscopy and retrogate pyelogram normal, squamous cells seen. What can be done, advise?

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I am a 45 y/o female and I have a h/o Lynch Syndrome and have already had uterine and colon cancer. I have had atypical urothelial cells in my cytology for a few years now. THe cystoscopy and retrograde pyelogram was normal 6 months ago. Recently I had some blood coming from my urethra mostly when I wiped the area. I have had no other sx for a next. I have an appt with my Dr next week.
Posted Wed, 23 May 2012 in Men's Health
Answered by Dr. G.Srinivasan 11 hours later

As you know, you are at high risk of urothelial malignancy also (renal pelvis, ureter, and bladder). I understand that you are in the right line of approach in getting urine cytology checked on a regular basis.

If repeated cytology shows evidence of atypical cells, in addition to cystoscopy and RGP (Retrograde Pyelogram), your doctor might consider doing flexible ureteroscopy and biopsy if necessary from the ureter or the renal pelvis/calyces.

Also, urothelial malignancy presents as blood mixed with urine and not the way described by you. The presence of blood on wiping the area may be due to a local cause in the urethral opening or the adjacent vaginal wall. Your physician might consider doing a local examination to look for the same.


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