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Bladder: Diseases, Screening & Treatments

The bladder is a triangle-shaped chamber in the lower abdomen. Like a balloon, the bladder’s elastic walls stretch and expand to store urine. They flatten following urination.

The kidneys remove wastes, control the body’s fluid balance, and regulate the balance of electrolytes. As the kidneys filter blood, they create urine, which collects in the kidneys’ pelvis — funnel-shaped structures that drain down tubes called ureters to the bladder.

Overactive Bladder

Overactive Bladder is a condition of the bladder causing a sudden urge to urinate. This condition is often associated with incontinence which is an involuntary loss of urine. To learn more about Incontinence please click here.

Bladder Cancer

Bladder cancer is the fourth leading cause of cancer and the seventh leading cause of cancer death. About 40,000 men and 15,000 women will develop bladder cancer this year in the United States. Each year, about 8,500 men and 4,000 women will die of the disease.

The bladder is lined with special cells called transitional cells. These are unique in that they can expand and deflate, which makes sense as the bladder fills and empties urine. Almost all bladder cancers are in this lining layer. These cancers in time can grow and spread into the underlying bladder muscle.

If bladder cancer spreads, it usually goes first to the lymph nodes in the pelvis. Bladder cancer also tends to spread to the lungs, liver, and bones.

At-risk Groups

Bladder cancer was one of the first cancers for which carcinogens were found to play a role in causing the disease.

Three of every five cases of bladder cancer is linked to smoking. This link between smoking and bladder cancer is especially strong among men.

Bladder cancer is more common in highly industrialized areas and among workers exposed to certain chemicals. Certain aniline derivatives, benzidine, 2-napthylamine, and other chemicals used in dye manufacturing increase the risk to workers involved in the process. Painters and workers in the rubber, metal, textile, and leather industries are also at high risk.

The artificial sweeteners saccharin and cyclamates have been shown to cause bladder cancer in animals when given in very large doses. The link between these sweeteners and bladder cancer in humans has not been shown.

Symptoms of Bladder Cancer

  • Blood in the urine
  • Frequent and urgent need to urinate
  • Pain during urination
  • Pain in the lower back and bones
  • Bowel problems
  • Loss of appetite
  • Weight loss

Many times, blood in the urine cannot be noticed by the individual, but is found by urine analysis done as part of a regular checkup or treatment for another medical condition. If blood can be seen in the urine, it may change the color of the urine from yellow to smoky to rusty to bright red. The blood may disappear for days or even weeks, only to reappear.

Diagnosis of Bladder Cancer

The diagnosis of bladder cancer begins with a complete medical history. The doctor will ask questions about the patient’s overall health and bladder cancer risk factors, such as smoking and exposure to certain industrial chemicals.

To determine if cancer is present, some or all of the following tests may be done:

  • Urinalysis is the analysis of the physical and chemical properties of a sample of urine. As part of the diagnostic work-up for bladder cancer, it can reveal blood in the urine in amounts too small to be noticed by the patient, or can confirm that blood is still in the urine.
  • CT Scan or Intravenous Pyelogram (IVP) can help determine the source of the bleeding. A small amount of special X-ray dye is injected into the bloodstream. This dye is quickly absorbed by the kidneys. X-rays are then taken to track the dye as it makes its way through the urinary system. The images displayed on the X-rays can locate tumors and other sources of bleeding.
  • Cystoscopy permits the doctor to actually look inside the bladder. A small, slender tube, the cystoscope, is inserted into the bladder through the urethra, the final portion of the urinary system. The cystoscope is fitted with a lens and a light which allows the doctor to carefully examine the inner surface of the bladder and look for any abnormal areas. This is usually done in the doctor’s office. The procedure takes only a minute to perform.
  • Resection and biopsy is the removal and examination under a microscope of suspicious- looking areas from the bladder. The cells are removed through the cystoscope. These procedures are usually performed in the hospital with an anesthetic. Only a biopsy can tell for sure whether cancer is present.
  • Cytology is the study of individual cells. The inside of the bladder is irrigated with a salt-water solution. The cells suspended in the solution are examined for any abnormalities. A PAP smear is an example of cytology when we look at scrapings from the female cervix.
  • Bimanual abdominal and rectal examination lets the doctor feel for any hard areas in part of the bladder. The doctor inserts a gloved finger into the vagina or rectum and then presses down gently on the abdomen. A hardened spot that can be felt may be a sign of a tumor.
  • Treatment of Bladder Cancer

    Surgery, alone or combined with other therapies, is used to treat more than 90 percent of bladder cancer patients. Radiation and chemotherapy can increase the chances for a cure, help keep the disease from spreading and keep it from coming back.

    If you are experiencing urinary incontinence or any problems related to your bladder call us to schedule an appointment for a complete evaluation to determine the best option for you.

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