Bladder malignant neoplasm Bladder cancer

Bladder tumors are the second cause of death due to urological cancer.

A number of risk factors are known to be associated with a higher incidence of this neoplasm, such as smoking, frequent exposure to certain chemicals or the presence of chronic inflammatory pathology in the bladder (such as chronic gall bladder, bladder schistosomiasis or pelvic radiation therapy).

The most frequent presentation of bladder tumors is hematuria, that is, the presence of blood in the urine. However, this disease can be asymptomatic until an advanced stage, so it is important to focus on early detection.

The diagnosis of this pathology usually requires the accomplishment of imaging examinations, often complemented with uretrocistoscopy, an examination that allows visualization of the interior of the bladder through a video system.

Bladder tumors are divided into two large groups: "superficial", when they do not invade the bladder muscle layer (about 75% of cases) and "invasive" when they invade this layer (about 25% of cases). To classify the tumor, we invariably proceed to a surgical intervention: transurethral resection of bladder neoplasia, usually referred to by the abbreviation TUR-B. This endoscopic surgery, performed through the urethra, consists of resection ("scraping") of the tumor, after which the removed tissue is analyzed under a microscope and assigned the respective classification.

Surface tumors are treated by TUR-B and localized medical therapy (administered into the bladder) for disease control.

In the case of tumors that invade the muscular layer of the bladder, the TUR-B approach is not sufficient. Thus, patients who are indicated for surgical treatment, will have to undergo radical cystectomy, which is the surgical removal of the bladder in its entirety, implying a urinary diversion.