Incidence of squamous cell carcinoma in patients with long-term catheter drainage

Long-term indwelling catheters constitute a risk factor for the development of bladder malignancy. We assessed prospectively by bladder biopsy and urine cytology 25 consecutive spinal cord injury patients catheterized for a minimum of 10 years. Two cases of squamous cell carcinoma of the bladder were identified. Both patients with cancer had positive cytology findings and hematuria, suggesting that routine bladder biopsy in the asymptomatic patient may not be warranted. The high risk of malignancy (8 per cent) in these patients is yet another compelling reason to minimize the use of long-term indwelling catheters.