WHAT IS URINARY BLADDER, WHAT IS ITS FUNCTION?

The urinary bladder is an organ which deposits the urine created by the kidneys and provides the urination.

WHAT IS THE CAUSE FOR URINARY BLADDER CANCER?

Cause is not definite in general. However, causes which are held responsible are SMOKING, long working period in PAINTING INDUSTRY (orthoaminophemol).

WHAT ARE TYPES OF URINARY BLADDER CANCER ?

98% of bladder cancers are epithelial and most of them are transitional cell carcinoma (TCC). 90% of all bladder cancers are transitional cell carcinoma.

WHAT ARE SYMPTOMS FOR URINARY BLADDER TUMOR?

Bloody urine (hematuria) is the first cancer observed in 85 to 90% of the patients with bladder cancer. Hematuria is generally painless; it may be visible (macroscopic), microscopic, intermittent or continuous. Some patients may have cystitis symptoms such as frequent urination, urinary incontinence (idrarını yetiştirememe yerine kullanılabilir mi?) or burning sense while urinating.

WHAT ARE RADIOLOGICAL IMAGING TESTS USED FOR THE DIAGNOSIS OF URINARY BLADDER TUMOR?

Intravenous urography (IVP) is a test which is frequently used to identify the hematuria.

Abdominal ultrasonography (US), Computed tomography (CT) and Magnetic Resonance (MRI) tests also show the occupying lesion within the bladder.

WHICH TESTS ARE USED AS URINARY BLADDER TUMOR MARKERS AND WHAT IS THEIR SAFETY?

Their specificity on diagnosis is not 100% safe. Some tests such as BTA stat – BTA TRAK – NMP 22 are used with different rates in the market today.

HOW IS FINAL DIAGNOSIS DETERMINED IN OR IN SUSPICIOUS OF THE URINARY BLADDER CANCER?

Although many imaging techniques are used for the diagnosis, FINAL DIAGNOSIS may be determined by cystoscopy and biopsy.

WHAT ARE STAGES OF URINARY BLADDER CANCER?

SUPERFICIAL (not deepened on the bladder wall) BLADDER CANCER

Here, it is meant that dissemination of the tumor has been superficial after the first operation and tumor has not invaded into the muscle tissue. (stage 0 – 1)

INVASIVE (deepened on the bladder wall) BLADDER CANCER

Burada tümörün ilk ameliyat sonrası yayılımının ilerlemiş olduğu , kas dokusuna ve hatta daha da ilerleyerek yağ tabakasına kadar tümörün ilerlemememiş olduğu kastedilir. (stage 2 – 3 – 4)

WHAT IS THE TREATMENT FOR URINARY BLADDER CANCER ?

SUPERFICIAL (not deepened on the bladder wall) BLADDER CANCER

The treatment method on early period of the disease is complete removal of the tumor with closed (endoscopic) techniques. TRANSURETHRAL BLADDER TUMOR RESECTION (TUR BT)

Just after the first operation on superficial bladder tumors; if the tumor is bigger than 2 cm, more than one, located badly, CIS is present or could not be cleared completely according to the experience of the urologist and/or possibility of relapse seems high, the bladder is irrigated once a week for a period between 6 and 8 weeks.

INVASIVE (deepened on the bladder wall) BLADDER CANCER

TUR BT operation which is applied first for these patients does not provide a definite treatment and additional treatment should be arranged. These therapies include: Radiotherapy, radical Cystectomy + urinary Diversion – Partial Cystectomy- Chemotherapy.

HOW IS MONITORING ORGANIZED IN SUPERFICIAL URINARY BLADDER CANCER ?

Recommended control endoscopy periods are quarterly within the first 2 years; every 6 months for the next 2 years and once a year after then. No relapse is based on this follow-up period. Follow-up periods start again by each relapse.

WHAT IS CYSTITIS, HOW DOES IT OCCUR?

Cystitis is the infection of the urinary bladder. It is generally seen as a result of reproduction of an infection agent in the urine and infecting the bladder wall.

WHAT ARE SYMPTOMS OF CYSTITIS?

Patients with this disease have frequent urination (pollakiuria), burning sense (dysuria) and pain (strangury) while urinating, urgent desire to urinate (urgency), awakening for urination at nights (nocturia). Sometimes, pain occurs after the urination and several drops of blood may be seen. The urine may also be bloody (hematuria). Patients say in general that their urine is cloudy and smells bad. Also, many patients have painful sexual intercourse (dyspareunia) complaint.

Abdominal sensitivity and even abdominal pain, nausea and vomiting may accompany to the symptoms in small children. FEVER is not PRESENT in general.

WHY CYSTITIS IS MORE IN WOMEN THAN MEN?

Urinary duct of women is quite shorter than men. The microbial agents, namely coli bacillus (Echericia Coli) are namely located in the perineum and reach to the urinary bladder via short urinary duct easily. Sexual intercourse contribute into the spread.

WHY SOME WOMEN HAVE CYSTITIS FREQUENTLY?

There are some risk factors for cystitis. Women who have these factors are inclined to have cystitis.

Risk factors for cystitis are bad genital hygiene, genital pH over 4.5, vaginal infections, vaginal diaphragm for contraception, pregnancy, diabetes, constipation, wearing tight and synthetic underwear, menopause and postponing the urination.

WHAT ARE METHODS OF PROTECTION FROM CYSTITIS ?

To be protected from cystitis or to rarefy cystitis attacks at least;

You should intake at least 1.5 to 2 liters of fluid. You send away the bacteria from your urinary bladder if they are or prevent their reproduction.

You should not postpone when you feel that you will urinate and you should clean your genital area from front to back.

If you are an individual who have cystitis frequently, you should not use bath tub, you should have shower.

You should wash your genital area before and after the sexual intercourse and urinate just after the intercourse.

You should make your vaginal cleaning with special shampoos of which the acidity was adjusted for genital region hygiene once a week.

You should wear cotton underwear and skirt instead of tight pants and synthetic underwear.

HOW IS TREATMENT ARRANGED FOR CYSTITIS ?

Although antibiotics are not always necessary for the treatment of the cystitis, it is generally treated with antibiotics. Anti-cholinergic agents, hot sitting baths, urinary analgesic agents may be added into the treatment.

WHAT IS CHRONIC BACTERIAL CYSTITIS, HOW IS THE TREATMENT ARRANGED?

It is an infection of the urinary bladder which repeats 3 or more times within a year and presents asymptomatic bacteriuria periods. Treatment should be performed with Antibiotherapy + urine acidification + long term suppressive antibiotic treatment with drugs including nitrofurantoin + TMP-SMZ in particular.

WHAT DOES NON-BACTERIAL CYSTITIS MEAN ?

It is defined as conditions which present a cystitis case clinically, but no bacteria can be reproduced in the culture.

a. Allergic cystitis

b. Infections with Gardnerella – Uroplasma – Candida or Herpes Simplex

c. radiation cystitis or chemical cystitis (cyclophosphamide)