E-Posters-Bladder Biopsies Taken using a Flexible Cystoscope are not Reliable for MAST Cell Counts

Bladder Biopsies Taken using a Flexible Cystoscope are not Reliable for MAST Cell Counts - Ellen S Morris

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Bladder biopsies taken using flexible cystoscopy may not be reliable for accurate MAST cell counts. Bladder Pain Syndrome (BPS), a chronic condition primarily affecting women in their 30s-40s, causes urinary symptoms and pelvic pain, significantly impacting quality of life. Cystoscopy with bladder biopsy is the gold standard for diagnosing BPS but carries risks such as pain, bleeding, and infection. MAST cells, which release histamine, are involved in the pathophysiology of BPS. Higher MAST cell counts (>28/mm2) are associated with a diagnosis of BPS.<br /><br />A retrospective study was conducted on women with lower urinary tract symptoms. Data was collected from patient records at a urogynaecology clinic between February 2014 and June 2019. The patients underwent either flexible or rigid cystoscopy, with the choice of procedure determined by the patient. Bladder biopsies were taken using a cold cup biopsy forceps, fixed in formalin, and analyzed using immunohistochemical staining and CD117 stain. The MAST cell count per square mm was determined using a graticule. Statistical analysis was performed, showing a significant association between the type of cystoscopy and MAST cell count.<br /><br />The study included 338 women, with 270 undergoing rigid cystoscopy and 68 undergoing flexible cystoscopy. Out of the women who had a biopsy, there were significantly more patients with a MAST cell count >28mm2 in the rigid cystoscopy group compared to the flexible cystoscopy group.<br /><br />The study concludes that flexible cystoscopy may underdiagnose women with high MAST cell counts in the bladder compared to rigid cystoscopy. This may be due to the smaller size of the biopsies taken during flexible cystoscopy. It emphasizes the importance of accurate diagnosis for appropriate treatment.<br /><br />Future work should ensure more equal group sizes for each type of cystoscopy and consider obtaining outcome measurements to assess the impact on patients' symptoms, treatment, and quality of life.

Keywords

Bladder biopsies

Flexible cystoscopy

MAST cell counts

Bladder Pain Syndrome

Urinary symptoms

Pelvic pain

Gold standard

Risks

Histamine

Accurate diagnosis