Cancer of the Bladder in Spinal Cord Injury Patients

Abstract

Since 1963, 10 cases of bladder carcinoma were detected in 1052 new admissions. A high percentage of these patients had squamous cell carcinoma and/or squamous elements. This relatively high incidence stimulated a prospective study of 81 spinal cord injury patients maintained on intraurethral catheter drainage for 10 yr or an external appliance for 15 yr. There were changes of squamous metaplasia in 19% of the cases but no cancer was detected. It remains undetermined if squamous metaplasia is a pre-malignant lesion. The incidence of squamous metaplasia and squamous cell carcinoma in paraplegics with chronically infected bladders is not uncommon. Any spinal cord injry patient with hematuria needs a complete bladder evaluation; and long-term paraplegic with chronic infection should undergo cystoscopy and Papanicolaou smears as part of the yearly checkup.