Bladder cancer

Bladder cancer

1. The color of urine always gives an indication!

2. Types

   • Benign
     • Papilloma
       • Leiomyoma
   • Malignant
     • TCC
       • SCC
         • Adenocarcinoma
           • Rhabdomyosarcoma

3. Signs and symptoms

   • Frequency
     • Painless hematuria
       • Dysuria

4. Risk factors

   • Smoking
     • Azo dyes
       • History of bladder infections
         • Catheters
           • Family history of bladder cancer
   • Schistosomiasis
     • parasite infection by Schistosoma mansoni, S. japonicum, S. mekongi, S. intercalatum and S. haematobium.
     • Transmission
       • fresh water containing larval forms (cercariae) of schistosomes, which develop in snails. Larvae penetrate the skin of individuals swimming or wading in water. Snails become infected as a result of excretion of eggs in human urine or faeces.
     • Symptoms
       • mansoni,, mekongi and japonicum causing hepatic and intestinal signs
       • Haematobium causing urinary dysfunction.

5. Investigations

   • Cytoscopy
   • Imaging
     • KUB X-ray
     • IVP
     • Retrograde pylogram
   • Urine cytology
   • Biopsy
   • Urinalysis
   • Culture sensitivity test

6. Affects the urinary bladder

   • Anatomy of urinary bladder
     • Blood supply
       • Superior vesical
       • Middle vesical
       • Inferior vesical
     • Picture
   • Histology of urinary bladder
     • Layers
       • Transitional epithelium
         • Lamina propria
           • Detrusor
             • Adventetia (with fat cells)
     • Urothelium
       • Distended
       • Empty
   • Physiology of renal tubules
     • Phases of micturition
       • Filling stage
         • Micturition reflex (emptying)

7. Epidemiology

   • 9th most common malignancy worldwide
   • Men are more than four times more susceptible to bladder cancer

8. Treatment and management

   • Superficial lesions
     • Endoscopic removal with intra-vesical therapy
   • Metastatic
     • Chemotherapy
       • Cisplatin
       • Paclitaxel
       • Gemcitabine
   • Invasive disease
     • Cystectomy with chemotherapy

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