Objective: To determine clinical correlations between the screening urinalysis (UA) and cystoscopy for the diagnosis of BI in patients with CC.

Material and Method: Medical records from the electronic database of CC patients treated in Songklanagarind Hospital between 2004 and 2013 were reviewed. All newly diagnosed CCs were scheduled for a cystoscopy to evaluate for BI. Those who had a UA sent within 100 days of cystoscopy were included. Data including patients’ age, stage at diagnosis, type of treatment received, and UA profiles were analyzed for their correlations with the cystoscopic results.

Results: Eight hundred seventy five cases were included in the analysis. Mean duration from diagnosis of CC to cystoscopy was 167 days. Cystoscopies were performed before treatment in only 238 cases (27.4%). The cystoscopic results reported negative study in 791 cases (90.4%). Among the cases with positive findings, 23 cases (2.6%) had BI, while the majority had chronic cystitis (6.7%). Tumor stages (III to IV), and time from diagnosis to do cystoscopy (those performed before treatment initiation) were associated with higher BI positivity rates. The UA parameters that were significantly associated with BI included proteinuria, bilirubinuria, nitrisuria, hematuria, and positive urine leukocytes. On multiple logistic regressions, proteinuria, and nitrisuria were the two parameters independently associated with BI at the OR 6.49 (95% CI 1.81 to 23.22) and 3.77 (95% CI 1.17 to 12.07), respectively. When the two parameters were considered together with the pre-cystoscopy status, the analysis showed that proteinuria and nitrisuria increased in the incidence of BI from 5% to 20 to 30% and 30% to 60 to 100% of stage III and IV cervical cancer, respectively.

Conclusion: Routine practice of cystoscopy in CC should be re-considered. As the yield is very low, the study might be avoided in early stages. Priority should be given to those with stage III and IV, especially when protein and nitrite are positive in the UA.

Keywords: Cervical cancer, Urinary bladder invasion, Urinalysis, Cystoscopy