CARCINOMA OF URINARY BLADDER;

EXTENT OF CARCINOMA OF URINARY BLADDER ON FIRST PRESENTATION AND ITS IMPACT ON MANAGEMENT

Abstract

Introduction: The most common presentation of carcinoma of urinary
bladder is haematuria. Almost 80-90% of patients with carcinoma of bladder present either
with microscopic or gross haematuria and it is mostly intermittent rather than constant. Some
patients also complain of irritative voiding symptoms such as frequency, urgency and dysuria.
Study Design: Descriptive, case series study. Setting: Department of Urology, DHQ Hospital,
Gujranwala, Pakistan. Period: July 2015 to June 2016. Materials & Methods: Total 30 patients
irrespective of age and gender with diagnosis of bladder tumor based on clinical symptoms
and supported by laboratory tools like Urine cytology, Ultrasound and IVU were included. The
already diagnosed patients of bladder tumor that have been treated with different modalities
were excluded. All the tumors were staged according to TNM classification after TURBT and
graded on the basis of histopathology. Results: Mean age was 53.17+16.07SD years. Males
were 25(83.3%) and females were 5(16.7%). Male to female ratio is 5:1. Twenty eight (93.3%)
patients out of 30 presented with painless haematuria. 23(73.33%) patients out of 30 patients
were smokers. 09 (30%) patients had Ta, in which G1 was found in 2 patients and G2 in 7
patients. T1 was found in 10 (33.3%) patients, in which G2 was 5(17.3%) and G3 was 5(17.3%)
cases. Muscle invasive T2a was diagnosed in 04 patients amongst them G2 and G3 was
detected in 2(6.6%) patients each respectively. T2b was present in 3 patients, which had G1 in
1(3.3%) and G3 in 2(10%) patients. T3b G2 was found 01 patient and T3b G3 was detected in
1(3.3%) patient, T4M1 G3 was present in 2(6.6%) patients. Conclusion: This study concluded
that the bladder tumor is quite common with muscle invasive TCC is more common. Painless
hematuria is the commonest presentation and also smoking has a definite association with CA
bladder.