title: [Bladder tumors. Diagnosis and therapeutic indications].
abstract: These originate from the vesical mucosa in 90p. 100 of cases. Hematuria was the first symptom in 3 cases out of 4. Intravenous urography and urinary cytology examined by Papanicolaou's method, are routine examinations for detection, but cystoscopy alone permits precise inventory of the lesions. Endoscopic resection and pathological examination of the fragments, will show the degree of malignancy of the tumour, its penetration in depth within the wall of the bladder, its degree of dedifferentation, all factors which with the site, the size, effects on the upper urinary apparatus and the existence of lymph node involvement on lymphography, may modify the indications for treatment. Benign or border line tumours which do not infiltrate the muscularis mucosae will be treated mainly by resection or endoscopic coagulation. Frankly malignant tumours should be treated by the association of cobalt and surgery. Partial cystectomy is sufficient for tumours of the mobile parts; total cystectomy is necessary for tumours of the trigone of the bladder with pass-by of the urine into the skin, by direct or transileal means, into the sigmoid or into an intestinal substitution bladder anastomosed to the membranous urethra. Treatment with radiotherapy alone should be reserved for patients in poor general condition and strongly dedifferentiated tumours.
mesh_terms: D000368:Aged; D003558:Cystoscopy; D005260:Female; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D001749:Urinary Bladder Neoplasms / Q000145:classification / Q000175:diagnosis / Q000601:surgery*; D014547:Urinary Diversion
vernacular_title: Tumeurs de vessie. Diagnostic et indications thérapeutiques