[Your patient with carcinoma of the urinary bladder. Options for organ preservation]

Every year, some 18,000 persons develop cancer of the bladder, making it one of the most common of the malignant diseases. Major underlying causal factors are exposure to aromatic amines, nicotine abuse, chronic infections and various medications. On the basis of the TMN system, a differentiation is made between superficial, invasive and metastasizing (lymphogeneous, hematogenous) carcinomas. A classical symptom is painless hematuria. The diagnosis is established primarily by white-light cystoscopy. Superficial urothelial lesions, which are often overlooked with this method, may be detected with the aid of the more sensitive method of fluorescence endoscopy. Depending upon local tumor spread and degree of differentiation, treatment includes transurethral electrocoagulation, laser coagulation, instillation of cytostatics and immunotherapeutic agents, as well as--in the case of muscle invasion--radical cystectomy.