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Bladder Cancer

Bladder Cancer

Bladder cancer is generally noticed in people over the age of 50. Quite often it is curable especially when it is found superficially on the surface of the bladder. At its more invasive and deeper stage, Bladder Cancer can be fatal. More instances of bladder cancer have been found in smokers, in particular those who have worked with PCB plastics or commercial dye industry.

This cancer occurs almost uniformly within the transitional cells of the bladder (the type of cell which lines the bladder wall). Transitional cell cancer is also found in the kidney and the ureter (the tube which connects the kidney to the bladder) although with much less frequency.

A urinalysis that shows an increased number of white blood cells without evidence of bacterial infection can lead to suspicion of bladder cancer. Urinalysis may also be remarkable for microscopic haematuria (blood in minute quantities). A cystoscopy allows the Urologist to look inside the bladder. This procedure is done under I.V. sedation or general anaesthesia. Cancer is detected with a biopsy or tissue sample. This is where a Pathologist can help in determining the extent of invasion of the cancer.

Chemotherapy agents are injected into the bladder through a catheter. These agents could include Adriamycin, BCG and other types of chemotherapy. If the bladder cancer is in an invasive stage, radical cystectomy may be required. This means a total surgical removal of the bladder. Radiation therapy which involves high doses of x-rays to localised body parts along with chemotherapy can be succesfully used to treat patients suffering from bladder cancer. When the bladder cancer has reached an advanced stage, it is generally incurable. A nutritious cancer diet is used to supplement the treatment.

Cystoscopy

Cystoscopy (cystouresthroscopy) is a diagnostic procedure of viewing a person's urinary passage and the urinary bladder, collecting urine samples and examining the prostrate gland through an instrument. The cystoscope is as thin as a pencil and has a light at the tip. Many cystoscopes have extra tubes to guide other instruments for procedures to treat urinary problems. Through a cystoscope, the urologist can focus on the inner surfaces of the urinary tract. Some cystoscopes use optical fibers that carry an image from the tip of the instrument to a viewing piece at the other end.

Ridid cystoscope: This is a solid straight telescope that is used along with a high intensity light source and a separate channel to allow other instruments to be attached.
Flexible cystoscope: This is used particularly for diagnosis and follow-up of most bladder tumors. It is a fibre optic instrument that can bend easily and has manoeuvarable tip that makes it easy to pass along the curves of the urethra.

Cystoscopy is also done to evaluate problems that cannot be seen on x ray. Cystoscopy is used to further investigate the problems detected by ultrasound or intravenous pyelography. In women, cystoscopy helps to reveal uterine prolapse. A common and temporary side effect of this test is swelling in the urethra. A urinary catheter may be left in the patient's bladder to help drain the urine until the swelling in the urethra subsides.

Urinary Retention

Acute urinary retention is usually caused due to swelling of the bladder, obstruction to the flow of urine or infection in the pelvic area. A problem with the nerves controlling the bladder function can also lead to inability to pass urine. A chronic problem of urinary retention can occur due to incomplete emptying of the bladder. Over time this results in urinary incontinence. Children can have birth defects that do not allow for free flow of urine. Persons who are more likely to suffer urinary retention are those who have had urinary system obstruction, urinary tract infection, long periods of bed rest or those on certain medications that cause narrowing of the urethra. Men suffering from prostate enlargement are likely to have urinary retention problems.

A person with acute urinary retention will feel pain in the lower abdomen. Fever and pain on urination is also noticed. There might be a painful urge to pass urine but there is inability to do so. A urologist will check for the cause of urinary retention as it might be indicative of another condition such as kidney stones, prostate cancer or urinary infection. A cystoscopy is done to insert a catheter.