Patient: Examination and laboratory tests: Ultrasound of both kidneys, bladder, and bladder residual urine volume were normal. Then a cystoscopy was done and a small calcified mass was found, which was removed for pathological pathology showing adenoid cystitis. Treatment: Anti-inflammatory drug flucloxacillin sodium capsule, want to do cystectomy as soon as possible History: two years ago, similar symptoms, urinary frequency and urgency, urine is not clean, pain when urinating, abdominal drop, had a cystoscopy, at that time to check the bladder wall there is a small piece of redness, the doctor said no big deal, so take a long time to eat Chinese medicine, and then gradually fine, but now again recurrence, and redo cystoscopy, found a small piece of calcified material, removed for pathology. The pathology was taken out for pathology, which showed adenoidal cystitis of the bladder. The local hospital recommended a minimally invasive electrodesiccation procedure. The doctor said that this is a pre-cancerous lesion of the bladder. I am very confused and lost. I would like to ask for your help, thank you very much. How many days do I need to stay in the hospital if I have surgery? How many times do I need to have chemotherapy after surgery? Can this disease really develop into bladder cancer? I hope you can confirm my diagnosis. Doctor: Hello Ms. Zhang! I am glad to answer your question. It seems that there are three main aspects of your entanglement: one is whether it can turn into cancer? Second is the question of treatment method, can it be completely cured? The third is whether the hospitalization time is long? I will answer you from these three aspects. First, whether it can turn into cancer? Simply put, adenocystitis is a chemotactic/proliferative lesion of the metastatic epithelium of the bladder, which is usually not uncommon in urology clinics and is commonly seen in women. The cause is not well defined and may be related to recurrent bladder infections, lower urinary tract obstruction (dyspareunia), and long-term irritation from bladder stones, foreign bodies, and urinary catheters. The diagnosis depends on cystoscopy + pathologic biopsy, which reveals typical structures such as “Brunn’s nest”, “cystic cavity” or “glandular epithelium”. It is generally accepted that the disease itself is benign and is a precancerous lesion with malignant potential, as cases of malignant transformation of adenocystitis have been reported. Because of the rarity of carcinogenesis, it has been suggested by statistical analysis of the literature that adenocystitis should be divided into high-risk (papillomatous, large villous edema, solid masses of verrucous, erythematous (intestinal adenoma-like) and extensive intestinal metaplasia) and low-risk (chronic inflammatory, small follicular and no significant mucosal changes) types based on cystoscopic findings. The low-risk type is considered to have no possibility of cancer and should not be considered as precancerous, but may develop into high-risk type if the irritating factors persist; the high-risk type has the possibility of malignant transformation within a short period of time and should be considered as precancerous. Low-risk types are much more common in clinical practice. Your case should be combined with your own cystoscopy and pathology report. From your description, the lesion is not large in scope and the pathology does not report intestinal epithelial metaplasia, so generally speaking, it is not a big problem, so don’t be too nervous. However, is the “calcified mass” seen under cystoscopy a bladder stone? I can’t tell because I didn’t see it directly, and I don’t know if I had a cesarean section. Can it be completely cured? The treatment of adenocystitis is divided into several areas: symptomatic treatment, removal of the cause, surgical treatment, bladder irrigation and other treatments. Symptomatic treatment is to control the symptoms of discomfort in urination. Removal of the cause includes control of infection, removal of obstruction, removal of stones or foreign bodies, etc. I am not able to determine the exact cause of your condition based on the available information, but it may be related to your long-term recurrent urinary tract infections and the stimulation of “calcified masses” on the bladder wall. Surgery is most often minimally invasive for transurethral lesions, and also includes surgery for bladder neck obstruction; total cystectomy should only be considered for extensive and severe lesions, serious comorbidities, and high suspicion of cancer. In your case, I think transurethral resection is more appropriate. As long as the lesion is completely removed and the possible causes are well controlled, it is possible to be cured. The hospital stay is usually about 5-7 days, and bladder irrigation can be performed regularly on an outpatient basis. Since your information is not complete, it is difficult to judge some cases accurately yet. I don’t know if my opinion is useful to you? I wish you a speedy recovery! Patient: I would like to thank you for your reply and would like to consult you on this. At that time, the cystoscopy report was not available and the examining physician said that there was a patch of redness and swelling near the bladder opening and a calcified material. In addition, the threshold of the lower urinary tract is high. Because I have to hold it for a while every time I urinate, I can’t pass it immediately. The doctor took out part of the calculus for pathology and diagnosed it as adenoidal cystitis. I have pictures of the pathology here, but not the cystoscopy. Is the distinction between high risk and low risk you are talking about looking at the cystoscopy pictures or the pathology pictures? Also I had a cesarean section. I’m not sure if it’s a bladder stone or not. Also, the doctor said that there is a redness and swelling is it a high risk lesion of the erythematous type you mentioned, i.e. adenoma-like intestinal lesion. I would like to hear from you. Thank you. Doctor: Hi Ms. Zhang! I have read your additional medical history and examination information. The typing mentioned last time is only a new viewpoint proposed by some scholars and is for reference only. From your medical history, 2 years have passed and no tumor growth has been seen, so you should not worry too much. You usually have poor urination, and lesbians are prone to urinary tract infection, so it is more appropriate to remove the diseased tissue and at the same time, to reduce recurrence factors, to do an electrodesection on the posterior lip of the bladder neck which is too high (that is, “high threshold of the lower urinary tract” as you said). The excised material will be sent for pathological examination to see the results. Thank you for your trust! Patient: Thank you very much for your patient and detailed reply in your busy schedule, now my inner burden is much lighter, I will follow your advice to actively treat and maintain a good attitude. Doctor: You are welcome!