About 5 years ago I had microscopic blood in my urine. Having had stones before and having some back pain, that’s what my doctor thought I had. No stones so had a cystoscope and they saw nothing.
Fast forwar to 2 weeks ago. I have 3 days of visible blood in my urine. Again no stones and I have another cystoscope. Nothing is seen again but this time the doctor takes urine straight from my bladder to test.
I get a call that the pathologist saw atypical Urothelial cells consistent with neoplasm. I’m scheduled for TURBT on Friday.
What does this all mean, and what happens if he still doesn’t see anything?
Well, you have discovered some of the issues with "sensitive" tests. All your urinary test result says is that there were some "atypical" cells present. Yes, bladder cancer can cause this....but these tests are notorious for "false positive" results, indicating a problem when none is present.. For example, if something like a low-level infection or some other irritation of the bladder lining is present you might well have "atypical" cells in your urine. This result is just an indication that further examination is in order. It is NOT diagnostic by itself.
Many things can cause microscopic or visible urinary blood, and most are NOT bladder cancer. In many cases, the cause is never found as you discovered five years ago.. This is why so many physicians do not even do a test for urinary blood routinely (and this is subject to differences of opinion.)
Your urologist now does need to do a TURB to see if there is any sign of cancer. It may very well be that there isn't any. In that case he will probably want to re-check you fairly frequently for a year or so.
Wishing you the best
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society