Summary
Definition
History and exam
Key diagnostic factors
- hematuria (gross or microscopic)
- dysuria
Other diagnostic factors
- urinary frequency
Risk factors
- tobacco exposure
- exposure to chemical carcinogens
- age >65 years
- pelvic radiation
- systemic chemotherapy
- diabetes mellitus
- Schistosoma infection
- male sex
- chronic bladder inflammation
- genetic predisposition
Diagnostic investigations
1st investigations to order
- urinalysis
Investigations to consider
- urine cytology
- cystoscopy
- renal and bladder ultrasound
- CT urogram
- MR urogram
- intravenous urogram
- CBC
- chemistry profile (including alkaline phosphatase)
- CXR
- CT abdomen and pelvis
- MRI abdomen and pelvis
- bone scan
- urinary biomarkers
Treatment algorithm
nonmuscle-invasive tumors
locally invasive tumors
metastatic disease
Contributors
Authors
Donald Lamm, MD, FACS
Director
BCG Oncology
Clinical Professor
University of Arizona
Phoenix
AZ
Disclosures
DL is an author of a number of references cited in this topic.
Acknowledgements
Dr Donald Lamm would like to gratefully acknowledge Dr Mary Heeley, the previous contributor to this topic.
Disclosures
MH declares that she has no competing interests.
Peer reviewers
Junaid Masood, MBBS, FRCS (Eng), MSc (Urol), FRCS (Urol)
Consultant Urological Surgeon
Homerton University Hospital NHS Foundation Trust
London
UK
Disclosures
JM declares that he has no competing interests.
Hugh Mostafid, MD
Consultant Urologist
North Hampshire Hospital
Basingstoke
UK
Disclosures
HM has received honoraria from GE Healthcare and Kyowa Kirin UK.
Thomas Guzzo, MD
Clinical Instructor of Urology
The James Buchanan Brady Urologic Institute
The Johns Hopkins Medical Institutions
Baltimore
MD
Disclosures
TG declares that he has no competing interests.
Amir Kaisary, MD, MA, ChM, FRCS
Consultant Urological Surgeon
Honorary Senior Lecturer
Department of Urology
The Royal Free & University College Medical School
London
UK
Disclosures
AK declares that he has no competing interests.
Differentials
- Benign prostatic hyperplasia (BPH)
- Hemorrhagic cystitis
- Prostatitis
More DifferentialsGuidelines
- NCCN clinical practice guidelines in oncology: bladder cancer
- Guidelines on muscle-invasive and metastatic bladder cancer
More GuidelinesPatient leaflets
Bladder cancer
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