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Bladder Cancer: Diagnosis

How is bladder cancer diagnosed?

If your healthcare provider thinks you might have bladder cancer, you’ll need certain exams and tests to be sure. Diagnosing bladder cancer starts with your healthcare provider asking you questions. He or she will ask you about your health history, symptoms, risk factors, and family history of disease. Your healthcare provider will also give you a physical exam that may include a rectal or vaginal exam. He or she may do this to check for the presence of tumors large enough to be felt.

What tests might I need?

You may have one or more of the following tests:

  • Urinalysis and urine culture

  • Urine cytology test

  • Bladder tumor marker tests

  • Cystoscopy

  • Intravenous pyelogram (IVP)

  • Bladder biopsy

Urine tests done in the lab

Urinalysis and urine culture

The goal of this test is to look for signs of infection or other problems that may be causing your symptoms. For the test, your healthcare provider checks your urine in a lab for blood, certain chemical levels, and signs of infection. The urine is cultured to see if organisms, such as bacteria, grow. It normally takes a few days for the test results to come back. A test that shows an infection may be the cause of your symptoms.

Urine cytology test

For this test, your healthcare provider looks at your urine in a lab under a microscope. He or she checks the cells to see if any of them look like they’re cancerous or precancerous.

Bladder tumor marker tests

These tests are used to look for markers or substances released by bladder cancer cells into your urine.

Imaging tests


This procedure lets your healthcare provider look at the inside of your bladder. It’s the best test for diagnosing bladder cancer. Your healthcare provider slides a thin, flexible tube with a tiny camera lens and light in it (cystoscope) through your urethra into your bladder. A salt water solution is put into your bladder through this same tube. This helps your healthcare provider see the inside wall of your bladder. If he or she sees anything that looks like cancer, a small piece of the tissue may be taken out for testing. Your healthcare provider may decide to take a urine sample with a bladder wash during a cystoscopy. This is when the salt water solution is removed, saved, and looked at under a microscope.

Intravenous pyelogram (IVP)

In this test, a contrast dye is put into a vein in your arm or hand. As the dye moves through and outlines your kidney, ureters, and bladder, your healthcare provider takes a series of x-rays. This test is used to find tumors, abnormalities, kidney stones, or any blockages. It’s also used to measure blood flow through your kidneys. It may also be used to rule out other diseases or check for spread (metastasis) of the bladder cancer to other parts of the urinary tract.

Bladder biopsy

A biopsy is a small sample of cells and tissue. A bladder biopsy is usually taken during cystoscopy. If your healthcare provider sees something that looks like cancer while doing the cystoscopy, he or she will remove a small sample of the tissue.

Your healthcare provider will send any removed tissue to a specialized doctor called a pathologist. This doctor looks at the tissue under a microscope for signs of cancer.

If there is cancer, the biopsy can help tell whether the cancer is just on the surface of the bladder or if it’s gone into the inner layers of the bladder wall.

It normally takes several days for the results of your biopsy to come back. A biopsy is the only sure way to tell if you have cancer and what kind of cancer it is.

Getting your test results

When your healthcare provider has the results of your biopsy, he or she will contact you with the results. Your provider will talk with you about other tests you may need if bladder cancer is found. Make sure you understand the results and what follow-up you need.

Online Medical Reviewer: Levin, Mark, MD
Online Medical Reviewer: Stump-Sutliff, Kim, RN, MSN, AOCNS
Date Last Reviewed: 6/1/2016
© 2013 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare provider's instructions.