Flashcards in Bladder Disorders Deck (21)
Patient presents with urinary frequency, burning sensations w/urination, hematuria, strong smelling urine, and feeling of discomfort in lower abdomen. What does this patient most likely have?
Bladder pain of variable severity lasting over a protracted period of time
Cells that play a central role in interstitial cystitis that damage urotheial lining
mast cells (histamine)
Only medical treatment available for interstitial cystitis
Pentosan polysulfate sodium
Requires work up especially in the older or smoking patient where it may suggest bladder cancer or renal disease
Why does bladder cancer present in patients with h/o includes repeated UTIs, kidney stones, chronic urinary retention requiring catheter.
Chronic inflammation of the bladder increases the risk of bladder cancer
Other factors besides smoking and recurrent infections that increase risk of bladder cancer
exposure to arsenic, irradiation, aromatic hydrocarbons
Helps lower risk of bladder cancer
increased fluid intake
Most common type of bladder cancer
transitional cell carcinoma
Most common presenting symptom or sign for bladder cancer
What type of hematuria does bladder cancer typically present with?
Most important method for the initial work-up of bladder cancer
cystoscopy with biopsy
Treatment of superficial lesions of bladder cancer (T0, T1S, T1, low grade T2)
endocscopic resection and fulguration w/cystoscopy. Repeat every three months
used prophylactically to prevent new lesions and delay or prevent development of both metastasis and muscle invading tumors, and therapeutically to eradicate an existing lesion
Intravesical Therapy with BCG
can be used for patients whose tumors are not amenable to transurethral resection of bladder tumor
Treatment for muscle invasive tumors (T2, T3, and T4)
Radical cystectomy with urinary diversion
Percentage of patients with high grade invasive disease who are cured?
no longer shown to be of benefit and is no longer used routinely is reserved for frail, elderly pts or those unfit for other approaches to pallliate local symptoms
are generally insensitive to chemotherapy and should NOT be considered for neoadjuvant bladder-sparing approach
non-urothelial (transitional) histology bladder cancer
5 yr survival rate for metastatic bladder disease