AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO025010559
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ORIGINAL RESEARCH ARTICLE

Ultrasound-guided core biopsy for bladder wall thickening in patients with prior bladder cancer: Initial clinical experience

Yue Wang1 ,  Shuxiong Zeng1 ,  Meitu Hua2 ,  Zhensheng Zhang1 ,  Chuanliang Xu1,2*
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1 Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
2 Department of Urology, Shanghai First People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
EJMO, 025010559 https://doi.org/10.36922/EJMO025010559
Received: 31 December 2025 | Revised: 14 March 2026 | Accepted: 1 April 2026 | Published online: 22 May 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Diagnosing ambiguous bladder wall thickening in post-treatment patients is challenging, particularly when advanced imaging suspects recurrence but cystoscopic mucosa appears normal. Thus, differentiating benign etiologies from occult recurrence in radiologic mural thickening beneath an intact mucosa is imperative to prevent unnecessary empirical resections and surgical overtreatment.

Objective: This study evaluates the technical feasibility, safety, and diagnostic yield of image-guided core needle biopsy (percutaneous or transurethral) as an alternative to empirical transurethral resection of bladder tumor (TURBT) or partial cystectomy in this specific scenario.

Methods: We retrospectively reviewed a pilot cohort of five patients (2019–2024) presenting with suspicious radiologic mural thickening beneath intact mucosa. An anatomically directed biopsy strategy using real-time ultrasound and spring-loaded core needles was applied: a percutaneous approach was selected for anterior/dome lesions, while a deep transurethral puncture was utilized for posterior/trigone masses obscured by pelvic organs.

Results: Tissue acquisition was technically successful in all five cases (4 percutaneous, 1 transurethral). Histological evaluation yielded adequate diagnostic tissue in all cases, enabling definitive pathological characterization. Pathological examination revealed benign etiologies (e.g., post-treatment fibrosis, benign urothelial/stromal tissue, and leiomyoma) across the cohort, effectively excluding muscle-invasive malignancy without requiring diagnostic TURBT. Over a mean imaging follow-up of 25.4 months, no procedure-related complications, such as clinical urine leakage, gross hematuria, or needle tract seeding, were observed.

Conclusion: This pilot study demonstrates that a tailored image-guided biopsy strategy is a feasible technical exploration for tissue acquisition. It serves as a safe “bridge” between non-invasive imaging and invasive resection, preventing overtreatment in complex diagnostic scenarios.

Keywords
Bladder cancer
Bladder wall thickening
Bladder wall puncture biopsy
Diagnosis
Benign and malignant bladder lesions
Funding
This research was funded by the National Natural Science Foundation of China (No. 81802515, 81801854, 82172871, 81972391, 82272950), the Discipline Development Plan of Changhai Hospital (No. 2019YXK041), the Science and Technology Commission of Shanghai Municipality (No. 20Y11904800, 22140903700), and Shanghai Municipal Health Commission (No. 2022YQ010).
Conflict of interest
The authors declare that they have no competing interests.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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