An important part of your doctor’s evaluation for hematuria is cystoscopy, either in the office or in the operating room. Sometimes your doctor can tell just by looking at your bladder wall through the cystoscope that there is a tumor that needs to be resected in the operating room . Other times, there will be an irritated area that could be either benign or malignant.
In these cases, a biopsy is necessary to deter-mine the cause of the abnormality. The biopsy is sent to the pathologist who will look at the tissue under the microscope. Under the microscope, it is possible to differentiate between normal bladder cells, cancer cells, inflammation, and benign tumors. If the pathologist decides that there is a tumor, he will then assign a grade (high or low) to the tumor. If the biopsy is adequate, the pathologist will also report how deep into the wall of the bladder the tumor extends.