Bladder TumourUro-Oncology Unit
Bladder tumours develop from the transitional epithelium or urothelium that covers the inside of the bladder.
Bladder tumours are more frequent in men, and Spain has one of the highest incidences in Europe. Tobacco use is responsible for 50% of cases, increasing the risk by 4 in comparison to non-smoking patients. It also has a relationship with environmental and occupational exposure (aluminium, dyes, paints, oil, rubber, textiles, etc.). Other causes include radiation on the pelvis, parasites (schistosomiasis), drugs such as cyclophosphamide, exposure to trihalomethanes from ingested water etc.
The most frequent symptomatology is haematuria (80-90%), which may be accompanied by clots. Another form of presentation are irritative urinary symptoms (in the absence of urinary tract infection), consisting of increased urination frequency, dysuria or itching and urinary urgency.
Colic pain can also appear, as a consequence of upper urinary tract obstruction, or systemic symptoms in metastatic cases, being rare (weight loss, anorexia, fever etc).
There are two entities with different prognoses and treatments: the non-muscle invasive bladder tumour, which respects the muscle layer of the bladder (75%) and the muscle-invasive bladder tumour which affects the muscle layer (25%). Optimal management of this disease requires an uro-oncology unit capable of treating it in all its stages.
- Urologists highly specialised in bladder cancer.
- Ultrasound of the urinary system.
- Flexible urethrocystoscopy.
- Urine cytology.
- Uro-CT and thoracoabdominal-pelvic CT.
- IV Urography.
- BLADDER EPICHECK®
The ultrasound of the urinary system is fundamental to the diagnosis, and allows the evaluation of the presence of masses in the bladder, renal masses and obstruction of the upper urinary tract.
The cystoscopy is the best diagnostic test and is necessary to monitor patients with bladder tumours. It consists of an endoscopy of the urinary bladder using a cystoscope inserted through the urethra. This must be done under sterile conditions. It allows direct visualisation of bladder tumours, observing their number, location and appearance.
The urine cytology consists of the anatomopathological evaluation of the bladder cells that are released in the urine. This test helps predict the tumour grade and the presence of associated carcinoma in situ.
The Uro-CT is fundamental in the diagnosis and monitoring of patients with bladder tumours, since it allows the evaluation of ureters, pelvis and renal calyces to rule out the presence of tumour implants in these locations. Upper urinary tract tumours can coexist with bladder tumours in 2-4% of the cases, rising up to 7% if the bladder tumour is in the trigone. In addition, thoracoabdominal-pelvic CT is used to rule out the presence of metastasis.