Leukoplakia of the bladder – does this diagnosis have a place in the era of evidencebased medicine?

Abstract

Over the past 15 years, the clinical diagnosis of «leukoplakia of the bladder» has become a frequently used diagnosis among outpatient and inpatient urologists. But how valid is it, what pathology does it describe and what are we treating? Most often it is established in patients with recurrent lower urinary tract infection (rLUTI), long-term dysuric disorders or chronic pelvic pain syndrome (CPPS). In most cases, it serves as a kind of «last resort» for the practitioner to find finally the cause of persistent complaints of the patient. In this «clinical trash» is thrown all that can potentially be associated with the bladder and is not treated by standard methods defined by clinical guidelines and generally accepted algorithms. At the same time, these are complex patients with a long history and multifactorial pathogenesis, requiring careful examination and thoughtful personalized approaches to treatment. Only such an attitude to the problem makes it possible to find the true cause of the patient's complaints. To date, the questions of the origin and treatment of patients with «leukoplakia of the bladder» remain very controversial. Unfortunately, the lack of knowledge in this matter often serves as a reason for unfair speculations and unjustified surgical activity. The data collected in this article should help practicing physicians to take a more sober look at the problem of «leukoplakia of the bladder» and learn how to help complex patients with persistent dysuria and chronic pelvic pain.