pubic area lump

Introduction

Introduction Patients with advanced bladder cancer may have symptoms such as pubic lumps, anemia, weight loss, edema, nausea and vomiting. Such as metastasis to the lymph nodes, invading most of the pelvic lymph nodes, pain, lower extremity radiation pain, lower extremity reflux disorders.

Cause

Cause

The cause is not fully understood, but is related to the following factors:

1 Environment and occupation have been affirmed, -naphthylamine benzidine-aminobisbiphenyl is a carcinogen of bladder cancer, an intermediate product for the manufacture of dyes or an anti-aging agent for the rubber and plastics industry. Long-term exposure to such substances is prone to bladder cancer.

2 other abnormalities of tryptophan and niacin metabolism may be the cause of bladder cancer, but other chronic diseases also have this abnormal parasitic in the bladder, schistosomiasis, bladder leukoplakia, urinary bladder retention, etc. may also be the cause of bladder cancer. .

Examine

an examination

(1) Urine routine: hematuria can be found that is invisible to the naked eye.

(2) double diagnosis of bladder: can examine the extent and depth of bladder tumor infiltration. During the examination, the doctor and patient should cooperate and the movement is gentle to avoid bleeding.

(3) cystoscopy: This is the main method for diagnosing bladder cancer. It can directly see the location, size, number, shape, and phlegm of bladder tumors. A tumor biopsy should be performed at the same time.

(4) CT examination: tumors and enlarged lymph nodes can be found, the accuracy rate is up to 80%, and it can help the correct staging of dry bladder tumors.

(5) B-ultrasound: This kind of examination of patients without pain. Accuracy is proportional to the size of the tumor. Generally, tumors over 0.4 cm can be found. The identification of bladder stones and tumors has an auxiliary value.

(6) cystography: generally used to supplement the lack of cystoscopy, such as the tumor is too large, can be used to view the whole picture. Multiple exposures showed that the bladder wall was stiff and could not be enlarged. Double contrast photography shows that the tumor is clearer.

(7) Urine exfoliation cytology: as an early diagnosis method for bladder tumors, it is easy for patients to accept because it is painless and convenient. However, when low-grade tumor cells differentiate well, it is difficult to distinguish them from normal cells that are caused by normal migration epithelial cells or inflammation. The urine exfoliated cells were examined by acridine orange staining: acridine orange is highly metachromatic and can bind to DNA molecules due to the biochemical changes of bladder cancer cells earlier than the morphological changes of cells. Fluorescence microscopy using acridine orange staining results in a sharp cell image that is easy to judge.

(8) Urine flow cytometry: The RNA and DNA in each cell of urine can be quickly determined in a very short time, so that the malignant potential of the tumor can be accurately estimated.

(9) Glucuronidase B (B-GRS): It is generally believed that an increase in intrauterine B-GRS has a tendency to develop bladder cancer.

(10) Photosensitive diagnosis of hematoporphyrin derivatives: For early diagnosis of bladder cancer, especially for tumors and carcinomas in situ that are difficult to determine by cystoscopy, the positive rate of diagnosis can be improved.

(11) Radionuclide 99mTc labeled blood stasis derivative diagnosis: This is one of the traumatic diagnostic methods for the diagnosis of bladder cancer, which can achieve the positioning diagnosis without cystoscopy.

Diagnosis

Differential diagnosis

1, renal, ureteral tumor hematuria characteristics is also the whole process of painless gross hematuria, similar to bladder cancer, can occur alone or with bladder cancer, upper urinary tract tumor caused by hematuria can appear strip or sickle clot, a clear diagnosis Need B-ultrasound, CT, urography and other examinations.

2, urinary tuberculosis in addition to hematuria, the main symptoms are chronic bladder irritation, accompanied by low heat, night sweats, weight loss, fatigue and other systemic symptoms, through the urine to find acid-fast bacilli, IVP, cystoscopy and other identification of bladder cancer.

3, the main symptoms of benign prostatic hyperplasia are progressive dysuria and frequent urination, sometimes gross hematuria, in the elderly, bladder cancer and prostate hyperplasia at the same time, the need for urine exfoliative cytology, B-ultrasound, CT, cystoscopy and other identification.

4, urolithiasis, hematuria is mostly microscopic hematuria, upper urinary tract stones can appear renal, ureteral colic, bladder stones can appear urinary interruption, by KUB plain film, B-ultrasound, cystoscopy, etc., due to bladder stones Stimulation of the local mucosa can lead to tumorigenesis. Therefore, when hematuria occurs in long-term bladder stones, the possibility of bladder cancer should be considered. If necessary, cystoscopy and biopsy should be performed.

5, glandular cystitis has obvious symptoms of bladder irritation, need cystoscopy and biopsy, simple cystoscopy sometimes misdiagnosed.

6, prostate cancer, hematuria, infiltration of the bladder appears, through the digital rectal examination, B-ultrasound, CT, biopsy and so on.

7, other such as radiation cystitis (more pelvic radiotherapy history, cystic telangiectasia, bladder mucosal ulcers and granuloma, need to be diagnosed by biopsy), cervical cancer (invasive bladder can appear hematuria, but generally First vaginal bleeding, vaginal examination can be identified) and so on.

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