Bladder Tumours at Tikur Anbessa Hospital in Ethiopia.

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 lowgrade, 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%), antiincontinence 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.