BOO, Residual Volume Of Urine & Bladder Cancer Risk
Research type
Research Study
Full title
Is there a relationship between bladder outlet obstruction, residual volume of urine and the development of bladder cancer?
IRAS ID
292684
Contact name
Sean Rezvani
Contact email
Sponsor organisation
Wrightington, Wigan & Leigh Trust
Duration of Study in the UK
1 years, 3 months, 0 days
Research summary
Summary of Research
Is there a relationship between bladder outlet obstruction, residual volume of urine and the development of bladder cancer?
There are many established risk factors for bladder cancer, including smoking and contact with certain chemical dyes. The body handles these cancer-promoting substances by filtering them into our urine so they can be excreted at a later time.
These substances are stored within our urine in the bladder until we are ready to go to the toilet. Contact between these substances within our urine and the lining of the bladder can sometimes stimulate changes that lead to bladder cancer.
We are investigating whether a higher ‘residual volume’ of urine i.e. urine left in the bladder, is associated with a higher detection rate of bladder cancer after a camera inspection in our clinic. This link has never been directly studied.
This will be a single-centre, analytical cross-sectional study. The study will use purposive sampling, recruiting patients referred to a haematuria clinic with either visible or non-visible haematuria. Eligibility will be assessed by a doctor or specialist nurse.
Standard care for patients referred to a haematuria clinic encompasses history, examination, urine dipstick and flexible cystoscopy to directly visualise any potential bladder tumours. In addition to this, each patient with haematuria will undergo some form of upper tract imaging through either ultrasound or CT.
Our intervention, above standard care, will involve a flow-rate measurement in males and a post-void residual measurement after flexible cystoscopy in both males and females. Both flow rate and post-void residual are non-invasive tests that carry little risk to patients.
Statistical analysis will be used to assess both our primary and secondary objectives using the data points collected from these clinics. The study will take 12 months to complete.
Summary of Results
This study looked at whether people who have trouble fully emptying their bladder are more likely to have bladder cancer.
We recruited 239 patients from four hospitals who were being investigated for blood in the urine. Everyone had a bladder scan to measure how much urine was left after passing urine (called the “post-void residual” or PVR).
We found that patients with bladder cancer had slightly higher amounts of urine left behind after urinating (a median of 16 mL compared with 2 mL in those without cancer). However, this difference was small and not large enough to be considered clinically significant. People with a larger residual volume (more than 50 mL) were more than twice as likely to have bladder cancer, although this finding did not reach statistical significance.
The results suggest that difficulty emptying the bladder may be linked to bladder cancer, but larger studies are needed to confirm this finding. The study has helped design future research that could look at whether treating bladder outlet obstruction reduces cancer risk.REC name
HSC REC A
REC reference
21/NI/0017
Date of REC Opinion
15 Feb 2021
REC opinion
Further Information Favourable Opinion