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Urothelial Carcinoma: Early Diagnosis through Hematuria Detection and Imaging Studies

A middle-aged Hispanic patient, dressed in a hospital gown, is seated on an examination table in a modern medical room. A Hispanic doctor, wearing a white coat and stethoscope, holds a digital tablet displaying a 3D image of the urinary system. The scene emphasizes the importance of early diagnosis and detection of urothelial carcinoma, highlighting hematuria and the use of imaging studies such as urograms and cystoscopy.

The urothelial carcinoma, also known as urothelial cancer, is the most common type of bladder cancer, accounting for over 90% of cases in industrialized countries. This type of cancer primarily affects older adults and is associated with risk factors such as smoking, exposure to chemicals, and chronic inflammation of the bladder. Hematuria, whether macroscopic or microscopic, is one of the most common symptoms leading to the detection of this type of cancer [1].

Early diagnosis of urothelial carcinoma is crucial for improving clinical outcomes. Urograms and cystoscopy are essential tools in the early diagnosis of this disease. Intravenous urograms, although less commonly used today, can be helpful in detecting abnormalities in the upper urinary system, as demonstrated in studies correlating poor visualization of the renal collecting system with invasive transitional cell carcinoma [2]. On the other hand, cystoscopy, especially when used with advanced techniques such as narrow-band imaging, can enhance the detection of suspicious lesions, although it may also increase the number of unnecessary biopsies [3].

In patients with kidney transplants, the detection of hematuria as a sign of upper urinary tract urothelial carcinoma may be associated with delayed diagnosis, underscoring the need for closer follow-up and the use of additional imaging studies to improve early detection [4]. Furthermore, the use of techniques such as FISH UroVysion has shown significant changes in diagnostic interpretation, suggesting an increase in the evaluation of patients with low-risk hematuria [5].

In conclusion, the early diagnosis of urothelial carcinoma through the identification of hematuria and the use of imaging studies such as urograms and cystoscopy is fundamental for improving patient prognosis. The integration of advanced techniques and a multidisciplinary approach can optimize the management of this prevalent disease, ensuring comprehensive and personalized treatment for each patient.

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Created 13/1/2025