Informative value of urothelial dysplasia in bladder mapping

During endoscopic treatment of 95 patients with 110 bladder tumors, multiple random biopsies were done from normal looking bladder mucosa. Dysplasias of urothelium were seen in only 25.4%. These findings are almost identical to the results of histological examination of bladders in autopsies. Postoperatively randomized mitomycin instillation therapy was carried out. Although the recurrence rate under mitomycin treatment was significantly lower than in the control group, the rate of dysplasias was nearly twice as high as in the control group. Therefore the conclusion can be drawn that dysplasia only reflects the present picture of proliferative activity of urothelium but allows no interpretation of the biologic activity or prognosis of bladder carcinoma.