Preoperative Diagnosis of Urinary Bladder Involvement in Adenocarcinoma of Colon and Rectum
Bunlue Chaleoykitti MD*
Affiliation : * Division of Colorectal Surgery, Department of Surgery, Phramongkutklao Hospital
Objective : Objective of the study was to compare urinary symptoms, urinalysis, computed tomography, intra-
venous pyelography, ultrasonography between colorectal adenocarcinoma with urinary bladder involve-
ment and without urinary bladder involvement.
Materials and Methods : 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.
Keywords : Bladder, Adenocarcinoma, Colon, Rectum
