Last reviewed: 19 Sep 2021
Last updated: 24 Jun 2021

Summary

Definition

History and exam

Key diagnostic factors

  • hematuria (gross or microscopic)
  • dysuria

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

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

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.

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