Risk of bladder cancer in patients with spina bifida: case reports and review of the literature.
OBJECTIVE
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.


CONCLUSIONS
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.
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Katelin
K
Mirkin
Jessica T
JT
Casey
Shubhra
S
Mukherjee
Stephanie J
SJ
Kielb
D000328:Adult; D002278:Carcinoma in Situ / Q000150:complications / Q000175:diagnosis; D002291:Carcinoma, Papillary / Q000150:complications / Q000175:diagnosis; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008591:Meningomyelocele / Q000150:complications; D008875:Middle Aged; D011379:Prognosis; D016135:Spinal Dysraphism / Q000150:complications*; D014057:Tomography, X-Ray Computed; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology
Spina bifida; bladder cancer; catheterization; neurogenic bladder