Bladder cancer

• Facts:
  Usually transitional cell carcinoma
• History / PE:
  Painless, gross hematuria that occurs at the end of voiding (terminal hematuria)
• Diagnosis:
  Cystoscopy with biopsy
• Treatment:
  Intravesicular chemotherapy (mitomycin-C or BCG)
  Radical cystectomy
  
• Pneumonic:
  Differential for hematuria ("S2 I3 T3")
  S trictures
  S tones
  
  I nfection
  I nflammation
  I nfarction
  
  T umor
  T rauma
  T uberculosis
• Differential Diagnosis:
  Polycystic kidney disease
  Renal cell carcinoma
  Urethral injury (initial hematuria)
• Risk Factors:
  1) Smoking
  2) Schistosomiasis (squamous cell cancer, rare)
  3) Chronic treatment with cyclophosphamide
  4) Occupational exposure to aniline dye (benzene derivative)