Association of Surgeons of East Africa and College of Surgeons of East Central and Southern Africa
Doi
Abstract
Background: Bladder cancer is the fourth to fifth most common cancer in
men, and the eighth in women These t umors are commonest in the 50 to
70 year age group The aim of this study was to review the pattern and
surgical management of bladder tumors at TAS in Ethiopia. Methods: A
hospital based retrospective cross sectional analysis was conducted in
TASH, department of surgery, Addis Ababa, Ethiopia. Patients’
medical records and operation theater registers of 97 patients operated
upon for bladder tumors, between January2006 and December 2008 were
analyzed. Results: Sixty patients were male and 37 female (M: F of
1.6:1). Their age ranged from 20 to79 years, with mean age of
49.73±1.5.Duration of symptoms ranged between 1and 48 months (mean
13.9). The most common presenting symptoms were hematuria in 89(91.8%).
cystoscopy and sonographic examination of the bladder were the main
modalities of investigation in the diagnosis of bladder tumors in 100%
and 96.9% patients respectively. Histopathologically, 87(89.7%) and
10(10.3%) patients had malignant and benign bladder tumors
respectively. Of the patients with malignant bladder tumors, 78 (80.4%)
had TCC, 5(5.2% SCC, and 3 (3.1%) adenocarcinoma. Common patterns of
bladder masses were papillary 77(79.7%), sessile or mixed 10(10.3%),
and nodular 6(6.2%).Upon presentation, 66(74.7%) of patients had
low-grade, whilst 20(23.0%) had high-grade disease, 85.5% of bladder
tumors were nonmuscle invasive, while 14.9% were muscle invasive, and
2.4% metastatic. The commonest surgical technique employed for bladder
tumor removal was TURBT in 80 (82.5%) patients. Forty-four (45%) of the
patients had additional surgery such as repeated TURBT in 16(16.5%),
cystectomy+ureterosigmoidostomy in 8(8.2%),radical
cystectomy+neobladder in 5(5.2%), anti-incontinence procedure in
4(4.1%),partial cystectomy in 4(4.1% ) and redo cystectomy+sigmoid
bladder in 4( 4.1%). In 83(85.6%) patients the postoperative course was
uneventful, while 17(17.5%) developed immediate postoperative
complications. Twelve developed late complications. There were 6(6.2%)
deaths. Post operative hospital stay of 1-70 days (mean 12.1) and a
follow up period ranging from 1 to 26 month (mean 3.7 months) were also
the outcome of this review. Conclusion: The most common type of bladder
cancer in TASH is TCC.Bladder tumor is more frequent in men than in
women. The commonest procedure for bladder tumors was TURBT
(p<0.001) which is the golden standared for non-muscle invasive
tumors