During endoscopic treatment of 90 patients with bladder tumors, multiple random biopsies were carried out on normal looking bladder mucosa. Dysplasias were found in 25.6% of the patients. These findings are almost identical to the results of histological examination of bladder in autopsies. Postoperatively, a randomized prophylactic Mitomycin instillation therapy was carried out. Although the recurrence rate under Mitomycin treatment was significantly lower here than in the control group (18.8% vs. 56.7%), the rate of dysplasias was nearly twice as high as in the control group (43.8% vs. 23.3%). Therefore, the conclusion can be drawn that dysplasia only reflects the present picture of proliferative activity of urothelium, but allows no interpretation of biological activity or prognosis of bladder carcinoma.
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