Differential diagnosis of bladder cancer

Hematuria is an important symptom of bladder cancer, and its differential diagnosis mainly focuses on the identification of hematuria. The hematuria of kidney and ureter tumors is similar to that of bladder tumors, and both can be intermittent and painless, but 90% of bladder tumors exist alone, and bladder tumor hematuria may be accompanied by urinary tract irritation symptoms or affect urination.

1. The hematuria of kidney and ureter tumors is similar to that of bladder tumors, both of which are intermittent and painless. However, 90% of bladder tumors exist alone. Bladder tumor hematuria may be accompanied by urinary tract irritation symptoms or affect urination. The hematuria may worsen at the beginning or end, and there may be blood clots or necrotic tissue. Kidney and ureter tumors do not have bladder irritation symptoms. Generally, it is not difficult to distinguish through B-ultrasound, CT scan, MRI scan, and urography.

2. Kidney tuberculosis and bladder tuberculosis Hematuria occurs after long-term frequent urination, and eventually worsens, with less urine output. It may be accompanied by symptoms of tuberculosis such as night sweats and weight loss. Urinalysis may detect tuberculosis bacteria. Tuberculous granulomas in the bladder may sometimes be misdiagnosed as bladder tumors. However, tissue biopsy can confirm the diagnosis.

3. Nonspecific cystitis mostly occurs in married women. Hematuria occurs suddenly and may be accompanied by bladder irritation symptoms, such as frequent urination, urgency, and pain during urination. Hematuria often occurs after or at the same time as bladder irritation symptoms. Nonspecific cystitis may occasionally cause painless hematuria throughout the course. Bacteria may be found in the urine.

4. The clinical manifestations of glandular cystitis are similar to those of bladder tumors and require cystoscopy and biopsy for differentiation. Urine cytology and tumor marker examinations are also helpful for differentiation.

5. Urinary tract stones hematuria is mostly microscopic hematuria. Upper urinary tract stones may cause renal and ureteral colic, and bladder stones may cause urination interruption. It can be identified through abdominal X-rays, B-ultrasound, cystoscopy, etc. Bladder stones can stimulate local mucosa and lead to tumors. Therefore, when long-term bladder stones cause hematuria, the possibility of bladder cancer should be considered, and cystoscopy and biopsy should be performed if necessary.

6. Radiation cystitis Radiation cystitis may occur after radiotherapy for tumors of pelvic organs such as the uterus, ovaries, rectum, prostate, and seminal vesicles. It usually occurs at the same time as radiotherapy or within 2 years. There may be hematuria and bladder irritation symptoms. Occasionally, painless hematuria may occur 10 to 30 years after treatment. Cystoscopy can show dilation of radioactive capillaries in the mucosa, and sometimes ulcers and granulomas may occur, which can be differentiated by cystoscopy and other examinations.

7. Prostatic hyperplasia Prostatic hyperplasia may cause urination difficulties or secondary infection, which may cause symptoms similar to bladder cancer. The diagnosis can be confirmed by cytology or cystoscopy.

8. Prostate cancer Prostate cancer invading the bladder may cause symptoms such as hematuria and difficulty urinating. The diagnosis can be confirmed by B-ultrasound, CT scan, MRI scan and rectal digital examination.