Urinary Bladder Papillomas
Papillomas usually present no symptoms and for this reason they may remain undiagnosed for a long time.
Introduction
Urinary bladder papillomas are a surface cancer of the urinary bladder. It is a condition requiring immediate treatment and the πρόγνωση και η εξέλιξη prognosis and progress of the illness depend directly on how soon the diagnosis and treatment are identified.
The wall of the urinary bladder consists of layers. Closest to the surface towards the tube, i.e. the bladder cavity, is a special epithelium, the urothelium, and deepest of all the muscles which are responsible for urinating. Papillomas usually appear at the urothelium and spread both to the tube and to the deeper layers. The determining development point is the muscle layer. When the illness reaches it then it is considered infiltrating and it is more severe.
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Symptoms of the Urinary Bladder Papillomas
Papillomas usually present no symptoms and that is why they may remain undiagnosed for a long time. A characteristic symptom is painless macroscopic haematuria which may appear, last for even one day and then automatically disappear and relapse some time later. Another symptom is frequent urination and urgent urination, while more rarely a papilloma, if it appears near the ureteral orifice may block the ureteral tube and cause hydronephrosis and kidney pain.
Diagnosis
Diagnosis for large papillomas can be done by ultrasound which will determine the diagnosis with great accuracy. However, a small papilloma will not appear in the ultrasound. Urine cytology may help in the diagnosis, however the most decisive and important test is cystoscopy: with the help of a camera inserted into the bladder from the urethra even the smallest papillomas will be identified.
Monitoring
The problem with papillomas is that they reappear because the disease relapses. Because the effective treatment of a papilloma takes place before it infiltrates the muscular layer, early diagnosis is very important. For this reason, after removal of a papilloma, the patient participates in a monitoring program through cystoscopies. In the case of a papilloma reappearance, it is again removed and if required, intravesical infusions and then new cystoscopies.
Treatment
Treatment is always surgical. A specialized tool is inserted via the urethra and removes the papilloma. Depending on its size, hospitalization may be needed or not, although usually one-day hospitalization is required.
Depending on the size and the number of papillomas, very frequently treatment is required after their removal by intravesical infusions. The medicine injected remains in the bladder for some time and then is urinated. Depending on the type of the papilloma, chemotherapeutic or immunostimulatory medicine may be used for intravesical infusions.
If it is shown that the papilloma has spread to the muscular layer, removal of the whole bladder is required or alternatively its irradiation (radiotherapy) often accompanied by intravenous chemotherapy.
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