BLADDER-TUMORS IN PARAPLEGIC PATIENTS ON RENAL REPLACEMENT THERAPY

Fourteen adult patients with end-stage renal disease due to spina bifida or spinal-cord injury underwent regular haemodialysis for 3-120 (mean 20) months. Seven of these patients received renal transplants. Urinary bladder tumours developed in four of the fourteen patients (three squamous-cell carcinoma in patients still on dialysis, one poorly differentiated transitional-cell carcinoma in a patient after successful transplantation). All four had widespread metastatic disease and died within 8 weeks of the diagnosis of cancer. We recommend regular urological evaluation for patients with neurogenic bladder even after initiation of dialysis treatment. Total cystectomy before transplantation might greatly reduce the risk of these rare tumours.