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[Diagnosis of the invasion of uterine cervical cancer to the bladder by transurethral ultrasonography and cystoscopy].

We studied the usefulness of transurethral ultrasonography in diagnosing the invasion of uterine cervical cancer to the bladder. Ten female patients with bladder tumors, as a control group, were examined by transurethral ultrasonography. The cervix of the uterus of them was clearly demonstrated on the tomogram. Fourty-two patients with uterine cervical cancer (FIGO stages 0 and I: 11 cases, stage II: 6 cases, stages III and IV: 22 cases, recurrence group: 3 cases) were examined by transurethral ultrasonography. The findings were classified into 3echo patterns according to the changes of the tomogram of the interface between the bladder wall and the cervix of the uterus. The criteria are as follows; BIo: the image of the bladder muscle layer adjoining the cervix of the uterus keeps thin smooth continuity. BI1: the image of the bladder muscle layer adjoining the cervix of the uterus is indented or destroyed, and an irregular hyperechoic area appears by the side of the uterus. BI2: the image of the bladder muscle layer is covered by the echoes growing from the cervix of the uterus. We concluded that BIo seen in 31 cases corresponded to negative signs of the tumor invasion to the bladder wall, BI1 in 9 cases to signs of the tumor invasion to the bladder muscle layer, and BI2 in 2 cases to signs of the tumor invasion to mucosa or submucosal layer of the bladder. The antero-posterior diameter and lateral diameter of the uterine cervical image were measured and "presumed ellipse area" was calculated in each stage of patients. The results showed that the more advanced the stage was, the larger became the uterine cervical size. As a result of cystoscopic examination performed in all cases at the same time, the findings such as flat mucosal edema and/or an elevated base of the bladder seemed to be not significant for diagnosing bladder involvement by uterine cervical cancer. Transurethral ultrasonography is considered to be a very accurate and objective method for diagnosing the invasion of uterine cervical cancer to the bladder.