Incidental Bladder Cancer at the Time of Routine Cystoscopy following Laparoscopic Hysterectomy

Three patients with abnormal uterine bleeding underwent uncomplicated minimally invasive total hysterectomy with routine cystoscopy. At time of cystoscopy, the patients had unexpected findings of bladder masses and postoperatively were expeditiously referred to urology. Final pathology for all revealed low-grade urologic carcinoma. The patients were treated with transurethral excision and are currently in surveillance without concern for recurrence. All three patients were asymptomatic at time of diagnosis. If the masses were not identified at the time of hysterectomy with cystoscopy, it is unclear when the patients may have developed symptoms to warrant a workup and likely would have experienced progression of the malignancy during that time. We hope this case series showcases that abnormal bladder masses are easily identifiable by the benign gynecologist at time of cystoscopy and illustrates another benefit of routine cystoscopy at time of hysterectomy.