What Is a Bladder Neoplasm?

Bladder tumors are the most common tumors in the urinary system. Most are transitional epithelial carcinoma. It is most common in the bladder sidewall and posterior wall, followed by the triangular area and the top, and its occurrence can be polycentric. Bladder tumors may be accompanied by tumors of the renal pelvis, ureter, and urethra. In foreign countries, the incidence of bladder tumors is second only to prostate cancer among male urogenital tumors, ranking second; in China it is the first. The incidence of males is 3 to 4 times that of females, and the age is mostly 50 to 70 years. Epithelial tumors account for 95% of the tissue types in this disease, and more than 90% of them are transitional epithelial carcinoma.

Basic Information

English name: tumorofbladder
Visiting department: Urology, Oncology
Multiple groups: 50 70 years old male

Common locations: Bladder sidewall
Common symptoms: Hematuria, bladder irritation, difficulty urinating, symptoms of upper urinary tract obstruction, lower abdominal mass, systemic symptoms, metastatic symptoms

Causes of bladder tumors

The cause of bladder tumors is not completely clear. Some of the more commonly recognized are: Long-term exposure to aromatic types of work, such as dyes, leather, rubber, painters, etc., can cause a higher incidence of bladder tumors. Smoking is also a cause of increasing the incidence of bladder tumors. Tryptophan metabolism in the body is abnormal. Local long-term irritation of the bladder mucosa. In recent years, certain drugs can also induce bladder cancer. Parasitic disease can also induce bladder cancer if it occurs in the bladder.

Clinical manifestations of bladder tumors

Hematuria

Hematuria is the most common first symptom of bladder cancer, and 85% of patients may experience recurrent painless intermittent gross hematuria. The amount of bleeding may be more or less, with severe blood clots. Hematuria occurs 100% of the time during the onset of bladder cancer.

2. Bladder irritation symptoms

The infiltration of cancer itself, cancer tissue ulcers, necrosis and infection, and blood clots can all be stimulating factors that cause the bladder muscles to contract and produce urination; frequent urination, urgency, dysuria, and persistent urination, and persistent back pain, Urinary incontinence occurs when the cancer invades and sphincter. The symptoms of bladder irritation are usually a sign of poor prognosis.

3. Difficulty urinating

About 7% of the cancerous tissue is shed or the tumor itself and the blood clot block the mouth of the bladder, causing dysuria, and even urinary retention.

4. Upper urinary tract obstruction symptoms

When the cancer invades the ureteral orifice, it can cause the hydronephrosis and even infection of the renal pelvis and ureteral orifice, which can cause back pain, lumbar pain, and fever to varying degrees. If bilateral ureteral orifices are invaded, symptoms of acute renal failure can occur.

5. Lower abdominal mass

About 3% of those with this symptom are the first symptoms. Most of them are adenocarcinoma at the top of the bladder or solid bladder cancer with high malignancy elsewhere. Rectal (or vaginal) digital examination or solution and unevenness of the lump, used to understand the extent and depth of tumor invasion of the bladder wall, which is helpful to the estimation of tumor stage.

6. Systemic symptoms

Nausea, loss of appetite, fever, weight loss, anemia, weakness, cachexia, leukemia-like reactions, etc.

7. Metastatic symptoms

The tumor spreads to the pelvis, retroperitoneum or rectum, causing low back pain, lower abdominal pain radiating to the perineum or thighs, rectal irritation symptoms, etc. Pelvic lymph node metastasis is more common, and metastases to the uterus, rectum, colon, liver, and kidney cause corresponding clinical symptoms of various organs.

Bladder tumor examination

Routine urine test

Concentrated urine to find pathological cells should be used as the preferred method of examination. Patients are easy to accept. Especially for people exposed to carcinogens, suspicious cells can be found a few months before the tumor is found by cystoscopy and urine cells can be found. This method is significantly better than urination tests.

2. Type B ultrasonic inspection

The accuracy of transabdominal B-mode ultrasound in diagnosing bladder tumors is directly proportional to the size of the tumor and also related to the experience and judgment of the examiner. The accuracy of tumor diameters greater than 1 cm is high, otherwise it is low.

3. Cystoscopy

Cystoscopy plays a very important role in the diagnosis of bladder tumors. It can observe the number, location, size, morphology, and relationship of ureteral orifices of tumors under direct vision. At the same time, biopsy can be performed to confirm the diagnosis. Essential basis for treatment planning.

4. Cystography

It is not widely used, but sometimes it can supplement the deficiency of cystoscopy. When the bladder volume is small or the bleeding is too heavy or the tumor is too large, it is often not possible to diagnose with cystoscopy when the cystoscopy is difficult to see the whole picture. It is better to use partial cystography.

5. Intravenous pyelography

Intravenous pyelography must be performed before the diagnosis of bladder tumors. It can exclude tumors of the renal pelvis and ureters, show ureteral obstruction caused by ureteric orifices or invasive lesions at the bottom of the bladder, and understand bilateral renal function.

6.CT inspection

Being able to understand the relationship between the bladder and surrounding organs, tumor invasion and extent, and whether there is metastasis in distant organs can help TNM staging and be very helpful in developing a treatment plan. In revealing bladder tumors and enlarged metastatic lymph nodes, the accuracy of CT diagnosis is about 80%.

7. Determination of tumor markers

Due to the development of immunology, the principle of immunity is used to find a way to diagnose early tumors. Including measuring the host's immune reactivity, deepening the understanding of the cells and estimating the prognosis; looking for specific and sensitive immune detection indicators-tumor markers. But so far most immunoassays are non-specific.