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Sbizzera M, Descotes F, Arber T, Neuville P, Ruffion A. Bladder cancer detection in patients with neurogenic bladder: are cystoscopy and cytology effective, and are biomarkers pertinent as future diagnostic tools? A scoping review. World J Urol 2022; 40:1897-1913. [PMID: 35119523 DOI: 10.1007/s00345-022-03943-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/16/2022] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To summarize the current state of knowledge on bladder cancer diagnosis and screening in neurogenic bladder patients, and to explore the potential contribution of biomarkers in this context. METHODS A scoping review was performed to retrieve cystoscopy and urinary cytology performance for bladder cancer detection in neurogenic bladder patients. We also retrieved information of certified urinary biomarkers in bladder cancer detection and their potential application for this specific population. RESULTS A total of 1092 articles were identified; 19 of them were included in the scoping review regarding cytology and cystoscopy performance in patients with neurogenic bladder and 33 were included as related to biomarkers in bladder cancer. No significant study stood out to recommend bladder cancer screening in this specific population using cytology and cystoscopy because of the scarcity of results, low level-of-evidence studies, and lack of studies specifically designed to assess the test performance in this population. Two biomarkers were retained as potential future diagnostic tools: FISH analysis to detect chromosomal changes, and PCR for TERT and FGFR3 promoter mutation detection, associated or not with KRAS mutation detection. CONCLUSION There is no sufficient quality data to support cystoscopy and urinary cytology as effective tools for the diagnostic and surveillance of bladder cancer in neurogenic bladder patients. FISH analysis to detect chromosomal changes, and PCR for TERT and FGFR3 promoter mutation detection, associated or not with KRAS mutation detection, stand out as candidates of interest for bladder cancer detection in this specific population and should be prospectively tested.
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Affiliation(s)
- Marc Sbizzera
- Department of Urology, Hospices Civils de Lyon, Centre Hospitalier de Lyon Sud, 165 Chemin du Grand Revoyet, Pierre-Bénite, 69310, Lyon, France.
- Equipe 2 - Centre d'Innovation en Cancérologie de Lyon (EA 3738 CICLY) - Faculté de médecine Lyon Sud, Université Claude Bernard Lyon 1, Villeurbanne, France.
| | - Françoise Descotes
- Department of Biochemistry and Molecular Biology, Hospices Civils de Lyon, Centre Hospitalier de Lyon Sud, 165 Chemin du Grand Revoyet, Pierre-Bénite, 69310, Lyon, France
| | - Théo Arber
- Department of Urology, Hospices Civils de Lyon, Centre Hospitalier de Lyon Sud, 165 Chemin du Grand Revoyet, Pierre-Bénite, 69310, Lyon, France
- Equipe 2 - Centre d'Innovation en Cancérologie de Lyon (EA 3738 CICLY) - Faculté de médecine Lyon Sud, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Paul Neuville
- Department of Urology, Hospices Civils de Lyon, Centre Hospitalier de Lyon Sud, 165 Chemin du Grand Revoyet, Pierre-Bénite, 69310, Lyon, France
- Equipe 2 - Centre d'Innovation en Cancérologie de Lyon (EA 3738 CICLY) - Faculté de médecine Lyon Sud, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Alain Ruffion
- Department of Urology, Hospices Civils de Lyon, Centre Hospitalier de Lyon Sud, 165 Chemin du Grand Revoyet, Pierre-Bénite, 69310, Lyon, France
- Equipe 2 - Centre d'Innovation en Cancérologie de Lyon (EA 3738 CICLY) - Faculté de médecine Lyon Sud, Université Claude Bernard Lyon 1, Villeurbanne, France
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Ismail S, Karsenty G, Chartier-Kastler E, Cussenot O, Compérat E, Rouprêt M, Phé V. Prevalence, management, and prognosis of bladder cancer in patients with neurogenic bladder: A systematic review. Neurourol Urodyn 2017; 37:1386-1395. [PMID: 29168217 DOI: 10.1002/nau.23457] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 11/02/2017] [Indexed: 12/28/2022]
Abstract
AIM To perform a systematic review of the literature regarding epidemiology, diagnosis, management and prognosis of bladder cancer in the neuro-urological patient population, in order to serve as a basis for future recommendations and research. METHODS A systematic review was performed according to the PRISMA-Preferred Reporting Items for Systematic Reviews and Meta-Analyzes Statement. Embase was searched for studies providing data on epidemiology, diagnosis, management and prognosis of bladder cancer in neuro-urological patients. RESULTS After screening 637 abstracts, 15 studies (13 retrospective and 2 prospective studies) were included in this study. We identified 332 patients (0.3%) who were diagnosed with bladder cancer. This mostly affected mostly men (59.3%) and spinal cord injured patients (98.8%). Mean age at diagnosis was 56.1 years. Bladder cancer occurred after a long period of evolution of the neurological disease (24.9 years). Gross hematuria was the predominating presenting symptom (31.6% of cases). Indwelling urethral or supra-pubic catheters were used in 44.5% of patients. The most frequent histological subtype of bladder cancer was transitional cell carcinoma (53.1%), followed by squamous cell carcinoma (33.5%). Muscle-invasive bladder cancer was reported in 67.7% of patients. The mean cancer-specific mortality rate was of 47.1%. CONCLUSIONS The prevalence and high mortality rate of bladder cancer in neuro-urological patients underlines the importance of long-term follow-up in this specific population. This highlights the necessity of further studies in this field.
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Affiliation(s)
- Salima Ismail
- Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie Medical School, Sorbonne Universités, Paris, France
| | - Gilles Karsenty
- La Conception Hospital, Department of Urology, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Emmanuel Chartier-Kastler
- Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie Medical School, Sorbonne Universités, Paris, France
| | - Olivier Cussenot
- Department of Urology, Tenon Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie Medical School, Sorbonne Universités, Paris, France.,Groupe de recherche clinique-UPMC n°5, Oncotype-Uro, Institut Universitaire de Cancérologie de l'UPMC, Pierre and Marie Curie Medical School, Sorbonne Universités, Paris, France
| | - Eva Compérat
- Department of Pathology, Tenon Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie Medical School, Sorbonne Universités, Paris, France.,Groupe de recherche clinique-UPMC n°5, Oncotype-Uro, Institut Universitaire de Cancérologie de l'UPMC, Pierre and Marie Curie Medical School, Sorbonne Universités, Paris, France
| | - Morgan Rouprêt
- Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie Medical School, Sorbonne Universités, Paris, France.,Groupe de recherche clinique-UPMC n°5, Oncotype-Uro, Institut Universitaire de Cancérologie de l'UPMC, Pierre and Marie Curie Medical School, Sorbonne Universités, Paris, France
| | - Véronique Phé
- Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie Medical School, Sorbonne Universités, Paris, France.,Groupe de recherche clinique-UPMC n°5, Oncotype-Uro, Institut Universitaire de Cancérologie de l'UPMC, Pierre and Marie Curie Medical School, Sorbonne Universités, Paris, France
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Polguer T, Boissier R, Gaillet S, Lenne Aurier K, Savoie PH, Lechevallier E, Coulange C, Karsenty G. [Treatment of detrusor-striated sphincter dyssynergia with permanent nitinol urethral stent: results after a minimum follow-up of 2 years]. Prog Urol 2012. [PMID: 23182120 DOI: 10.1016/j.purol.2012.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The aim of this study was to assess the outcomes of nitinol permanent urethral stents used in detrusor-striated sphincter dyssynergia (DSD) treatment on male patients with a spinal cord injury. MATERIALS We investigated retrospectively all patients treated from 2004 to 2012. A total of 22 patients were included, with an age ranging from 22 to 76 years old. The DSD syndrome was due to spinal cord injury (18) or various spinal cord diseases (four) and treated with a nitinol urethral stent (11 Ultraflex(®) and 11 Mémotherm(®)). Every patient had an urodynamical study. The follow-up reached at least 2 years. RESULTS The mean follow-up was 56 months (± 14). Complementary procedures after stenting included: five stent prolongation or displacement (mean interval 7.6 months), six bladder neck incisions (12.2 months), three urethrotomy (42 months), ten obstruction treated by laser (47.3 months). Eight patients had a change of their urinary pattern: four underwent ileal conduit diversion, one had a continent urinary diversion, one chose self intermittent catheterization, two were under indwelling catheterization waiting for another treatment. Stent retrieval was either harmful or impossible for four of them. Three patients were free of complementary procedures. CONCLUSIONS Nitinol urethral stent was an effective treatment initially. However, by the third year, urethral stenosis and hypertrophic growth of the urethral mucosa usually require iterative endoscopic procedures (0.31 per patient per year). Patients treated with permanent uretral stent deserve a yearly endoscopic follow-up. Safety and effectiveness of permanent uretral stent compared to surgical sphincterotomy to treat DSD are discussed.
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Affiliation(s)
- T Polguer
- Service d'urologie, hôpital Gabriel-Montpied, université d'Auvergne, CHU de Clermont-Ferrand, 58, rue Montalemberg, 63000 Clermont-Ferrand, France
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Guillotreau J, Panicker JN, Castel-Lacanal E, Viala F, Roumiguié M, Malavaud B, Marque P, Clanet M, Rischmann P, Gamé X. Prospective evaluation of laparoscopic assisted cystectomy and ileal conduit in advanced multiple sclerosis. Urology 2012; 80:852-7. [PMID: 22939550 DOI: 10.1016/j.urology.2012.06.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 06/13/2012] [Accepted: 06/23/2012] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To assess the morbidity, mortality, and impact on quality of life and renal function after laparoscopic cystectomy and ileal conduit in patients with multiple sclerosis with lower urinary tract symptom refractory to conservative management. MATERIALS AND METHODS A prospective study was conducted between February 2004 and December 2010 on 44 consecutive patients with multiple sclerosis who underwent laparoscopic cystectomy and ileal conduit for lower urinary tract symptom. Median Expanded Disability Status Scale score was 8 (6.5-8.5). Mean duration of multiple sclerosis was 19.3 ± 7.9 years. The quality of life was determined using the validated Qualiveen questionnaire preoperatively and at minimum 6 months after the surgery. RESULTS No conversion to open surgery was required. Postoperative morbidity rate was 18.2%; minor (Clavien ≤ 2) and major (Clavien ≥ 3) complications occurred in 13.6% and 6.8%, respectively. Mean follow-up was 44.5 ± 20.6 months. Complications noted were asymptomatic ureteroileal stenosis (n = 6) and pyelonephritis (n = 3). Neurological status and Expanded Disability Status Scale score remained stable throughout. Renal function remained unchanged. Limitations, constraints, and specific urinary impact index subscores of the Qualiveen were significantly improved at 6 months time. CONCLUSION Laparoscopic cystectomy and ileal conduit for lower urinary tract symptom in advanced multiple sclerosis is a safe procedure with low complications. Neurological status and renal function remain stable and quality of life improves and continues to remain improved during long-term follow-up, suggesting this to be an attractive option in patients with advanced multiple sclerosis with lower urinary tract symptom refractory to conservative treatment.
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Affiliation(s)
- Julien Guillotreau
- Département d'Urologie, Transplantation Rénale et Andrologie, CHU Rangueil, Toulouse, France
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Vaidyanathan S, Soni BM, Mansour P, Singh G, Hughes PL. Invasive carcinoma of urinary bladder in a patient with a spinal cord injury with non-functioning Brindley sacral anterior root stimulator: a case report. CASES JOURNAL 2008; 1:137. [PMID: 18761737 PMCID: PMC2546370 DOI: 10.1186/1757-1626-1-137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2008] [Accepted: 09/01/2008] [Indexed: 11/10/2022]
Abstract
Background Anterior sacral root stimulation combined with sacral posterior rhizotomy restores bladder function in spinal cord-injured patients suffering from hyperactive bladder. After successful implantation of bladder stimulator, urinary infection rate decreases, and patients are able to get rid of indwelling urinary catheters, which in turn reduce the risks for vesical malignancy. We present a spinal cord injury patient with non-functioning Brindley sacral anterior root stimulator, who developed carcinoma of urinary bladder. Case presentation A Caucasian male, who was born in 1943, sustained paraplegia at T-4 (ASIA-B) in 1981. This patient underwent implantation of sacral anterior root stimulator in September 1985. The bladder stimulator started giving trouble since 1996 and the patient went back to using indwelling urethral catheter. In August 2006, this patient passed blood in urine after a routine change of indwelling catheter. Cystoscopy showed unhealthy bladder mucosa. Bladder biopsy revealed carcinoma, which was infiltrating bundles of muscularis propria. Many of the nests showed evidence of squamous differentiation, while others could be transitional or squamous. This patient underwent cystectomy with lymphadenectomy in March 2007 in a hospital nearer his home. Histology showed three nodes involved. This patient has been doing well since the operation. Conclusion Occurrence of vesical malignancy in this patient with non-functioning bladder stimulator is a timely reminder to all health professionals, and health care managers that concerted efforts should be made to rectify a non-functioning sacral anterior root stimulator as soon as possible. Otherwise, facilities should be made available in the community for the spinal cord injury patient to use intermittent catheterisation and thereby, avoid permanent indwelling catheter, vesical calculi and urine infections, which are risk factors for bladder cancer.
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Parra J, Drouin S, Comperat E, Misraï V, Van Glabeke E, Richard F, Denys P, Chartier-Kastler E, Rouprêt M. Cancers de la vessie chez les patients neurologiques : analyse d’une série monocentrique. Prog Urol 2007; 17:1333-6. [DOI: 10.1016/s1166-7087(07)78572-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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