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What is A 55-year-old smoker presents with a history of five episodes of macroscopic hematuria each lasting for about 4-5 days in the past five years. Which of the following investigations should be performed to evaluate the suspected diagnosis and explain in detail?
In this case, we should suspect carcinoma of the bladder ( transitional cell carcinoma ). Smokers are at a higher risk of developing TCC. It is more common in males -TCC(3:1). They usually present with painless gross hematuria. Thus the best investigation is urine microscopy and cytology for RBC's and malignant cells.
Other investigations for TCC include IVU, cystoscopy, biopsy/resection, USG abdomen to see bladder wall, pelvis, liver, lymph nodes, CT scan, MRI abdomen.
We can also suspect renal cell carcinoma which presents with haematuria and pain; more common in males and in smokers, for which urine microscopy is done for RBC's