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video of cystoscopy of patient 5

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Patient 5
76-year-old man.
Referred 2 years ago because of nocturia and bladder pain at full bladder. Voiding diary demonstrates
nocturnal polyuria.
Urodynamics: normal
Office cystoscopy: red areas in the anterior and left bladder wall
Tentative diagnosis: carcinoma in situ
Cystoscopy: selected site biopsies including the red areas.
Morphology: no malignancy.
Send back to GP
Rereferred 5 months later for gross hematuria
Cystoscopy: red areas with fibrin deposits on the anterior and right bladder wall including the
bladder top.
Cystoscopy under general anaesthesia: ecchymosis in the right side. The areas are coagulated after biopsy, but the surgeon decides to take deep biopsies for mast cells.
Morphology: chronic infammation and detrusor mastocytosis.
After 1 month: considerable improvement in symptoms but still nocturia and pain on full bladder in
the night.. Scheduled for cystoscopy for BPS, but because of symptom improvement is this first
done 17 monts later.
Cystoscopy GA: Capacity 660 ml. Hunner lesions. Mast cell count 26/24.
After 3 weeks: No pain. Nocturia x 1.

video: Jørgen Nordling










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