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Dr. Tharun
Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3682
Experience:  MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
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What are the treatment options for thickening of the urinary

Customer Question

What are the treatment options for thickening of the urinary bladder wall? I had a small early cancer fulgurated and a year's course of BCG four + years ago Last years endoscopic exam proved tumor seemed to have gone !! Now I have emiction problems and a CT scan showed wall thickening. I am confused Best regards.
Submitted: 3 years ago.
Category: Urology
Expert:  Dr. Tharun replied 3 years ago.

Dr. Tharun :

HI

Dr. Tharun :

When was the cystoscopy done ?

Dr. Tharun :

By Emiction - Do you mean problems while passing urine ?

Customer:

I have had increasing difficulty in starting and voiding urine for about three months. I cannot say for certain the cystoscope was I think about a year ago.

Customer:

I am a retired biochemist and can understand elementary medical term

Customer:

The CT scan I had was last October

Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3682
Experience: MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
Dr. Tharun and other Urology Specialists are ready to help you
Expert:  Dr. Tharun replied 3 years ago.

HI

 

So do you smoke ?

 

Blood in urine ?

 

Prostate issues?

 

Any medications for the prostate?

 

CT scan - is the thickening generalized or at specific parts only?

 

Please let me know.

 

Dr.Tharun

Customer: replied 3 years ago.

The first four queries are answered - no smoking,no blood seen.no prostate issues or medication( Not sure about occult blood).


I cannot say about thickening as I have not been told - I assume it is general


Best regards MJC

Expert:  Dr. Tharun replied 3 years ago.
HI Michael,

Thanks for the information.
Thickening if it is general , indicates that there is muscle hypertropy of the bladder muscles known as detrusor hypertrophy. This most commonly happens due to block in the urine flow. The extra work needed for the bladder to pump the urine increases the size and number of the bladder muscles leading to thickening. This is generalised and occurs as a whole unit.

Very rarely it could be due to CIS - carcinoma in situ , which is cancer of the bladder mucosa.But in such cases there is usually urinary symptoms like frequency, irritation, urgency and blood in urine.So it is a distant possibility but should be kept in mind due to your history of bladder cancer.
Cystitis - bladder infection can also cause bladder wall thickening- but again there would be tell tale symptoms of infection like dysuria, pain and fever.
So I would advise you to get a cystoscopy done as soon as possible to rule out cancer.
Doing a urine routine to see for microscopic blood would also be advised.

If it is generalised wall thickening without cancer , then we have to look for a reason. At this age most common reason for this prostate enlargement blocking the flow of urine.This can lead to bladder wall thickening to compensate for the block.That would explain the difficulty in starting urination.

Another reason is neurogenic dysfunction which can lead to sphincteric dyssynergia (un-coordinated). This is due to the aging process which can damage the nerves as well as due to spinal problems.

So the foremost priority should be a cystoscopy. If negative it should be followed by ruling out other causes( as I mentioned above). Cancer will require treatment according to its merit. Prostate enlargement will respond to medications and so will sphincteric problem.

If you have any doubts or questions, please let me know.

Dr.Tharun.

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