Diagnosis and treatment of bladder tumors in Moscow

Diagnosis

First of all, the urologist takes an anamnesis (including family history) and conducts a physical examination. Large tumors are often determined by palpation (palpation of the pelvic area).

The patient must be sent for echography (ultrasound). Normally, homogeneous (homogeneous) contents of the bladder are determined. The tumor is usually visualized as a hypo- or isoechogenic mass with indistinct contours and a heterogeneous structure.

If a hyperechoic formation in the bladder (areas with increased density) is detected during the scan, there is a possibility that these are calculus formations (stones).

The thickening of the walls of the bladder is always associated with an increased load on the tissues caused by certain factors, including the tumor process. Bladder hypertrophy may indicate, for example, a narrowing of the urethra against the background of prostate adenoma or the development of polyps and papillomas.

In addition, X-ray examination with a contrast agent (excretory urography, ascending or descending cystography) is performed.

The most informative methods of hardware diagnostics are computed and magnetic resonance imaging (CT, MRI). To suspect cancer allows the detection of exophytic formation of the bladder. It looks like a polyp and grows upward from the mucous membrane.

When imaging the pelvic organs, a trabecular bladder can be detected - powerful intertwining muscle fibers (trabeculae) with depressions (so-called false diverticula). This picture most often appears with a tumor of the prostate gland.

Please note: A cauliflower-shaped tumor (papillary overgrowth) with a high degree of probability indicates a malignant nature of the neoplasm.

As part of the differential diagnosis, cystoscopy (endoscopic examination) is performed with a biopsy for histological and cytological examination. Laboratory study of the obtained biomaterial makes it possible to establish the type of tumor.

The patient must also take blood tests (general clinical and biochemical) and urine. Cytological examination of urine helps to identify both tumor lesions and non-tumor changes in the epithelial layer (urothelium).

Treatment

The tactics of managing the patient is determined taking into account the nature of the pathology, the volume of the tumor, the age and general condition of the patient.

Superficial formations in the bladder in men are an indication for surgical intervention - laser transurethral or transvesical resection of a tumor with a wall fragment.

For diagnosed cancer, follow-up endoscopy with contrast is performed once every 3 months for the first 2 years, and then twice a year. Photodynamic diagnostics using a special lamp allows you to distinguish healthy tissues from affected ones.

In a non-invasive form of cancer, immuno- and chemotherapy are used. Immunotherapy involves the introduction into the cavity of the organ of the BCG vaccine - a suspension of viable but weakened bacilli of bovine tuberculosis (bacilli Calmette-Guerin). The most effective chemotherapeutic agent is the mitosan antibiotic Mitomycin C, which has pronounced antitumor properties.

In case of invasive malignant tumors (with germination into neighboring organs), a radical operation is indicated, i.e. organ resection. Cystectomy is performed by open or laparoscopic access.

After removal of the organ, the surgeon creates urine excretion routes using sections of the ileum previously isolated from the gastrointestinal tract. One end of the segment is sutured to the ureter, and the other end is brought to the anterior abdominal wall (a so-called urostomy is created).

An alternative technique is to create a holding reservoir with a valve into which the catheter must be inserted periodically. Cystectomy with Studer orthotoplasty is considered the gold standard. The operation involves the connection of a segment of the intestine with the ureters and urethra, i.e., the creation of a virtually complete organ that eliminates the need to wear a urinal.

Detection of secondary tumor foci (metastases) is an indication for radio- and chemotherapy.

Benign tissue growths are eliminated with the help of minimally invasive interventions. Most often, diathermocoagulation (cauterization) or electroresection by laparoscopic access is performed.

Prevention

Specific measures for the prevention of tumors of the urinary system have not yet been developed. It is recommended to visit a urologist if even the most minor problems with the urinary system appear. Persons over 40 years of age should have an annual blood test for tumor markers.

Other preventive measures:

1. using drinking water filters;
2. nicotine withdrawal;
3. compliance with safety regulations when working with chemicals;
4. timely treatment of diseases of the urogenital system;
5. regular medical examination.

Sign up for an appointment with urologists at the K+31 Medical Center. Early diagnosis and timely treatment of pathologies will help maintain health, increase the duration and quality of life.

Our doctors conduct examinations and treatment in strict accordance with the standards of modern evidence-based medicine. Patients are guaranteed complete anonymity; data on detected diseases and therapeutic measures taken are not subject to disclosure.