Bladder cancer has the highest recurrence rate of any malignancy
1. Pathophysiology
Transitional (urothelial) cell carcinoma: 90%
Squamous cell carcinoma: 5%. persistent inflammation from long-term indwelling Foley catheters and bladder stones, as well as, possibly, infections. In developing nations, SCC is often associated with bladder infection by Schistosoma haematobium
adenocarcinomas: 2%
Small cell carcinoma: 0.3-0.7%
2. Signs and symptoms
Painless gross hematuria - Approximately 80-90% of patients; classic presentation
Irritative bladder symptoms (eg, dysuria, urgency, frequency of urination) - 20-30% of patients
Pelvic or bony pain, lower-extremity edema, or flank pain - In patients with advanced disease
Palpable mass on physical examination - Rare in superficial bladder cancer