Urology - Bladder

The urinary bladder is an organ located in the small pelvis devoted to collecting the urine produced by the kidneys. For this purpose it is hollow, muscular and very elastic. Urine arrives through the ureters and is expelled periodically through the urethra; urination, that is the process of emitting urine, is a periodical process, governed by a reflex in the spinal cord that stimulates the smooth muscle fascia that makes up the bladder itself. Below you will find information on Cystitis and Bladder Cancer.

 

Cystitis

Cystitis is an inflammation of the urinary bladder, often accompanied by urethritis; it is caused generally by bacterial infection, but it can also originate through viral or fungal infection or in cases of bladder cancer.

This is not a rare complaint, above all in women who are much more exposed given the shorter urethra compared with men, which can allow bacteria to rise more easily towards the bladder. 

A frequent need to urinate, cloudy urine, even with more or less evident traces of blood, and intermittent urine flow during urination, in addition to possible suprapubic pain are symptoms that reveal cystitis.

For the purpose of choosing an appropriate antibiotic therapy, an urologist will often request a urine culture in order to decide which remedy is the most appropriate. 

Bladder Cancer and Follow-up

For the most part, bladder cancers are carcinomas (95%1), that is neoplasms generated by epithelial tissue, and in particular by transitional cells. Other less frequent kinds are adenocarcinoma, mixed carcinomas, with small or squamous cells.

The use of tobacco in smoking is the main cause of cancer in this organ (80% of neoplasms are attributable to this cause), and follow exposure to particular substances not in common use, such as arsenic or industrial textile colouring agents, prior radiotherapy in the pelvic area, and an unhealthy fat-based diet

The symptoms that can be observed are common to several other disorders of the urinary apparatus, and for this reason it is most important to be examined by a specialist in order to determine the underlying causes of the perceived issues, and thus to decide whether to perform further tests and/or to decide on the most suitable therapy. In Italy, screening programs for prevention do not yet exist, notwithstanding that it is the second most common tumour in urology. It should be said that since it is not asymptomatic, it is diagnosed for the most part in cases when it is at the initial stage, and only rarely when it is already in an infiltrating stage. 5 year survival applies to about ¾ of patients.

  1. http://www.airc.it/tumori/tumore-alla-vescica.asp 
Early Diagnosis

Ruling out cancer in a suspected case is fairly easy: ultrasound scans and radiology techniques such as urography and CT, and the first methods of investigation. Furthermore urine analysis (urinary cytology) may revel the presence of tumour cells. 

Another outpatient approach consists of cystoscopy. This is an endoscopic system, which as the name suggests, consists of going up the urethra with an optical fibre as far as the bladder, both to see inside and to take tissue samples.