Role of chronic catheterization in the development of bladder cancer in patients with spinal cord injury

West, Douglas A.; Cummings, James M.; Longo, Walter E.; Virgo, Katherine S.; Johnson, Frank E.; Parra, Raul O.

doi:10.1016/s0090-4295(98)00517-2

Cited by 145 publications

(27 citation statements)

References 16 publications

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“…The most common bladder tumors in patients with spinal cord injury are SCC (33-46.9%), urothelial carcinoma (31.3-55%), and adenocarcinoma (9.4-10%) [4-6]. In the literature SCC is more common in patients with indwelling urethral and suprapubic catheters than other forms of bladder management.…”

Section: Discussionmentioning

confidence: 99%

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A case of squamous cell carcinoma arising from a suprapubic cystostomy tract

et al. 2011

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BackgroundPatients with spinal cord injury and a chronic indwelling urinary catheter are known to have an increased risk of bladder malignancy. However, squamous cell carcinoma (SCC) of the epidermis around a suprapubic cystostomy is relatively rare. Here, we report a case of lower abdominal SCC arising from the suprapubic cystostomy tract.Case presentationA 58-year-old man with a complete spinal cord injury was referred to our hospital with a chief complaint of an abdominal mass. Abdominal enhanced computed tomography (CT) showed a 7-cm mass surrounding the suprapubic cystostomy and bilateral inguinal and para-aortic lymph nodes metastasis. Histopathological examination of percutaneous biopsy specimens was performed. The diagnosis was stage IV (cT4N1M1) epidermal SCC, which was treated with palliative external radiation therapy.ConclusionThe SCC in this case was thought to arise from mechanical stimulus of the suprapubic cystostomy. Physicians and patients should pay careful attention to any signs of neoplasms with long-term indwelling catheters, such as skin changes around the suprapubic cystostomy site. This case presentation is only the fourth report of SCC arising from the suprapubic cystostomy tract in the literature. In cases of unresectable tumors and contraindications to chemotherapy, palliative radiotherapy may lead to disease remission and symptom relief.

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Section: Discussionmentioning

confidence: 99%

“…However, the risk of SCC would not have been eliminated by intermittent catheterization, as demonstrated by reported cases bladder malignancies in patients who perform intermittent catheterization [4,6,8]. …”

Section: Discussionmentioning

confidence: 99%

A case of squamous cell carcinoma arising from a suprapubic cystostomy tract

et al. 2011

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“…An indwelling urethral catheter increases the risks of UTI, renal impairment, bladder stone formation, urethral stricture, urethral erosion, and bladder cancer 54,55. A study of patients with SCI-neurogenic bladder dysfunction who were followed for more than 20 years indicated that indwelling catheters, whether suprapubic or urethral, were associated with increased prevalence of upper tract scarring and caliectasis when compared with CIC, sphincterotomy, or vesicostomy.…”

Section: Conservative Managementmentioning

confidence: 99%

Neurogenic bladder in spinal cord injury patients

Taweel

Seyam

2015

RRU

171

182

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Neurogenic bladder dysfunction due to spinal cord injury poses a significant threat to the well-being of patients. Incontinence, renal impairment, urinary tract infection, stones, and poor quality of life are some complications of this condition. The majority of patients will require management to ensure low pressure reservoir function of the bladder, complete emptying, and dryness. Management typically begins with anticholinergic medications and clean intermittent catheterization. Patients who fail this treatment because of inefficacy or intolerability are candidates for a spectrum of more invasive procedures. Endoscopic managements to relieve the bladder outlet resistance include sphincterotomy, botulinum toxin injection, and stent insertion. In contrast, patients with incompetent sphincters are candidates for transobturator tape insertion, sling surgery, or artificial sphincter implantation. Coordinated bladder emptying is possible with neuromodulation in selected patients. Bladder augmentation, usually with an intestinal segment, and urinary diversion are the last resort. Tissue engineering is promising in experimental settings; however, its role in clinical bladder management is still evolving. In this review, we summarize the current literature pertaining to the pathology and management of neurogenic bladder dysfunction in patients with spinal cord injury.

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“…Instead, as previously discussed, patients with indwelling Foley catheters should maintain high (>3 liters/day) oral fluid intake to keep the colonized bacteria flushed from the bladder and the catheter should be changed monthly. Other complications of indwelling catheters include bleeding, urethral or bladder injuries, bladder sediment/stones, catheter malfunction (including obstructions), bladder perforation, rectovesical fistula, and bladder cancer [29, 34–36]. For male patients, many experts recommend using the smallest diameter urinary catheter feasible and to tape it to the lower abdominal wall under low tension to minimize the risk of urethral erosions [37].…”

Section: Neurogenic Bladder Managementmentioning

confidence: 99%

“…Bladder stones occur in up to 65% of individuals with suprapubic catheters compared to 30% of those performing intermittent catheterization [39]. There are rare reports of bladder cancer, though with less than half the risk associated with use of urethral catheters [36]. Suprapubic catheters should also be changed routinely, and some experts [40] recommend changing the catheter at the average time it takes for the catheter to obstruct for each patient (one to several weeks).…”

Section: Neurogenic Bladder Managementmentioning

confidence: 99%

Neurogenic Bladder

Dorsher

McIntosh

2012

Advances in Urology

151

126

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Congenital anomalies such as meningomyelocele and diseases/damage of the central, peripheral, or autonomic nervous systems may produce neurogenic bladder dysfunction, which untreated can result in progressive renal damage, adverse physical effects including decubiti and urinary tract infections, and psychological and social sequelae related to urinary incontinence. A comprehensive bladder-retraining program that incorporates appropriate education, training, medication, and surgical interventions can mitigate the adverse consequences of neurogenic bladder dysfunction and improve both quantity and quality of life. The goals of bladder retraining for neurogenic bladder dysfunction are prevention of urinary incontinence, urinary tract infections, detrusor overdistension, and progressive upper urinary tract damage due to chronic, excessive detrusor pressures. Understanding the physiology and pathophysiology of micturition is essential to select appropriate pharmacologic and surgical interventions to achieve these goals. Future perspectives on potential pharmacological, surgical, and regenerative medicine options for treating neurogenic bladder dysfunction are also presented.

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Role of chronic catheterization in the development of bladder cancer in patients with spinal cord injury

Cited by 145 publications

References 16 publications

A case of squamous cell carcinoma arising from a suprapubic cystostomy tract

A case of squamous cell carcinoma arising from a suprapubic cystostomy tract

Neurogenic bladder in spinal cord injury patients

Neurogenic Bladder

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