Congenital Anomalies
Bladder Extrophy
Developmental failure of
the anterior abdominal
wall
Bladder exposed to the
outside
Predisposes to infection
Adenocarcinoma of
bladder
Cystitis
Acute & chronic Predisposing factors:
Acute : Female sex: short urethra
E.coli -90% cases Indwelling catheter
Proteus, klebsiella Diabetes
Adenovirus Drugs: Cyclophosphamide
Chronic : haemorrhagic cystitis
TB, Schistosoma Parasitic infection:
Schistosoma
haematobium infection
CYSTITIS
Symptoms Diagnosis
Dysuria Urine : Pus cells
Increased frequency, urgency Dipsticks : nitrite ,leucocyte
Suprapubic pain esterase +
Sometimes haematuria Culture
Diverticula
Congenital Acquired
- benign prostatic hyperplasia
Predisposes to stone
formation , infection
BLADDER NEOPLASMS
Benign Malignant
Transitional cell Papilloma Transitional cell carcinoma >
Very common 95%
Squamous cell carcinoma
Adenocarcinoma
Urothelial (Transitional cell) tumors
90% of bladder tumors
Precursor lesions
Male, 50-80yrs
Cigarette smoking
Occupational exposure to dyes-beta
naphthylamine
Treatment with cyclophosphamide
Parasitic infection : Schistosoma haematobium
( endemic in egypt, Sudan)
Chronic NSAID use
4 morphological patterns
Good
prognosis
Papillary – non-invasive Flat – non-invasive
Invasion
of
muscle
Papillary – invasive Flat -invasive
Transitional cell carcinoma
Site :Lateral/posterior
walls
Papillary/nodular/flat
May be multifocal
Transitional cell carcinoma
Papillary type:
Papillae lined by
transitional cells
with a fibrovascular
core
Clinical features
Painless hematuria – most common feature
in > 75% of the cases
Urgency, dysuria
Obstruction of urteral orifice :
Pyelonephritis,Hydronephrosis
Squamous cell carcinoma
Usually in a chronic infection with Schistosoma
haematobium infection
Chronic irritation…. Squamous
metaplasia….dysplasia….squamous cell carcinoma