Bladder Cancer Diagnosis and Treatment for Patients with Neurogenic Bladder: Does the Literature Support a Different Approach?

Purpose of Review In this review, the current literature available to patients and providers on the diagnosis and management of bladder cancer in patients with neurogenic bladder will be discussed. Topics include bladder cancer epidemiology in the neurogenic population and unique features of this tumor in this subset of patients, current screening recommendations, and differences in the treatment for this patient population, outlining specific changes in the surgical approach. Recent Findings Neurogenic lower urinary tract dysfunction (NLUTD) patients are living longer due to better care, and cancer is becoming more frequent. This is partly due to the aging of this population, as well as intrinsic factors related to the underlying condition or urinary diversion, which poses a greater risk of developing genitourinary malignancies. There are multiple studies published that have investigated this specific patient population, most derived from large cohorts of patients with spinal cord injury. Summary Although there is more evidence on screening for bladder cancer, specific screening protocols for different underlying conditions and urinary diversion are lacking. Few studies have looked prospectively into the management of bladder cancer in this subset of patients, and good quality evidence for tailoring the care of this population is lacking. Nonetheless, surgical complications are expected to be greater in this scenario.