Affiliations: Department of Urology, Northwestern University
Feinberg School of Medicine, Chicago, IL, USA | Department of Physical Medicine and Rehabilitation,
Rehabilitation Institute of Chicago, Chicago, IL, USA
Note: [] Corresponding author: Stephanie J. Kielb, 303 E Chicago Avenue,
Tarry 16. Chicago, IL 60611, USA. Tel.: +1 312 695 8146; Fax: +1 312 908 7275; E-mail: [email protected]
Abstract: PURPOSE: This article presents four cases of patients with
spina bifida who developed bladder cancer while under our care and provides a
literature review on the incidence, initial presentation, possible etiologies,
and role for screening for bladder cancer in the neurogenic bladder population. METHODS: Case reports of four patients are presented followed by a
literature review of the current available studies. RESULTS: Patients with spina bifida present with bladder cancer at an atypically young age with
very advanced disease. The dire prognosis associated with bladder cancer in
these patients demands that we provide better treatment, diagnosis, and
prevention modalities. However, the potential morbidity, financial burden, and
lack of proven benefit discourage cystoscopic screening in this patient
population. Until we have more data on how to best serve spina bifida patients,
this population should receive careful and regular urologic follow-up. CONCLUSION: Given the atypical young age of presentation and very advanced
nature of bladder cancer in the spina bifida population, the authors strongly
recommend that any new bladder changes, such as including increased urinary
leakage, pain, recurrent infections, or increased gross hematuria, prompt
immediate urologic referral for endoscopic evaluation and biopsy as indicated.
