Management of Bladder Tumors: What Results in 10 Years of Practice at the University Clinic of Urology-Andrology of the CNHU-HKM of Cotonou?

Abstract

Introduction : Bladder tumors are the 2nd largest urological cancer with an increasing incidence of about 1% per year. The aim of our study was to determine the prevalence of bladder tumors at the University Clinic of Urology-Andrology of the National University Hospital Center Hubert Koutoukou Maga of Cotonou, to describe the diagnostic aspects, and to evaluate the therapeutic modalities used. Patients and Methods: This was a descriptive, retrospective, and analytical study with a cross-sectional data collection, listing 68 cases of bladder tumors over a 10-year period from January 2013 to December 2022. Results : Men predominated (67.65%) with a sex ratio of 2.09. The mean age of patients was 57.22 ± 13.79 years, with extremes of 16 years and 89 years. The age group of 60 to 69 years was the most represented and made up 29.41% of patients. Hematuria was the main reason for consultation (45.59%). History was dominated by smoking (17.65%) and urinary schistosomiasis (14.71%). One of the patients was exposed to occupational carcinogens. The clinical picture was dominated by conjunctival pallor (47.1%) and deterioration in general condition (42.65%). Para clinically, pelvic ultrasound was performed by 88.24% of patients with a sensitivity of 77.84%. Cystoscopy performed by 36 patients (52.94%) confirmed the lesion in 97.22% of cases. The tumors were budding (88.57%), sessile (97.14%) and multifocal (20%). The non-muscle infiltrating bladder tumor accounted for 51.47% of cases. Histopathological examination was performed in 22 patients (32.35%) with a predominance of urothelial carcinoma. Forty patients (58.82%) had received treatment, including 38 surgeries and 2 endovesical instillations. A total of 61.76% of patients were lost to follow-up, 8.82% had progression-free follow-up, 2.94% had tumor regrowth, and 26.47% died. Conclusion: Bladder tumours remain a public health problem. Diagnosis is clinical and, above all, paraclinical. The best treatment is to prevent risk factors.