You have accessJournal of UrologyBladder Cancer: Detection & Screening1 Apr 20131283 LOWER URINARY TRACT SYMPTOMS (LUTS) AS A PRESENTING SYMPTOM FOR BLADDER CANCER IN A VETERAN POPULATION Ryan Dobbs, John Petros, Usama Al-Qassab, Chad Ritenour, Muta Issa, and Daniel Canter Ryan DobbsRyan Dobbs Atlanta, GA More articles by this author , John PetrosJohn Petros Atlanta, GA More articles by this author , Usama Al-QassabUsama Al-Qassab Atlanta, GA More articles by this author , Chad RitenourChad Ritenour Atlanta, GA More articles by this author , Muta IssaMuta Issa Atlanta, GA More articles by this author , and Daniel CanterDaniel Canter Atlanta, GA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2637AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients with bladder cancer usually present with either gross or microscopic hematuria. The incidence of lower urinary tract symptoms (LUTS) as the sole presenting symptom for bladder cancer has traditionally been reported to be low (1-2%). The objective of this study is to evaluate the prevalence, characteristics, and outcomes of patients with bladder cancer who originally presented with LUTS in the absence of hematuria. METHODS We queried our database of bladder cancer patients at the Atlanta Veteran Affairs Medical Center (VAMC) to identify patients who presented solely with LUTS and were subsequently diagnosed with bladder cancer. Demographic, clinical, and pathologic variables were examined. RESULTS 4.4% (14/321) of bladder cancer patients in our series presented solely with LUTS. All patients were males. Mean age was 66.4 years (range=52-83). 7.1% (n=1) were African-American (AA) with the remainder being non-African American. Mean Charlson Co-morbidity Index and tobacco use were 3 (range=0-7) and 34.4 (range=0-70) pack-years, respectively. The mean IPSS, Bother and Quality of Life scores at presentation were 24.0, 20.4, and 4.2. In our small cohort, 7 (50.0%), 4 (25.0%), and 1 (7.1%) patients presented with clinical stage Ta, CIS, and T2 disease, respectively. Two (14.3%) patients had unspecified non muscle-invasive bladder cancer. The incidence of low and high-grade disease was equal: 50.0% (n=7) and 50.0% (n=7), respectively. Median follow-up was 51.96 months (range=28 days-128.26 months). Recurrence occurred in 5 (35.7%) patients with progression occurring in 1 (7.1%) patient who refused further treatment despite multiple positive cytologies. The patient that presented with cT2 disease was managed definitively with a radical cystoprostatectomy and bilateral pelvic lymph node dissection. At last follow up, 11 (78.6%) patients were alive without bladder cancer recurrence, and 3 (21.4%) patients had died. Only 1 (5.9%) death was attributable to bladder cancer. CONCLUSIONS In contrast to prior reports, our database shows a greater percentage of patients with bladder cancer who present solely with LUTS. Furthermore, analysis of staging data at presentation demonstrates that a majority of patients with LUTS as their initial symptom did not have CIS at the time of tumor resection. Although this patient population is highly enriched with patients who are smokers and have a history of chemical exposure, this study suggests that urologists should have a low threshold for evaluating patients with irritative symptoms for underlying bladder cancer. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e525 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ryan Dobbs Atlanta, GA More articles by this author John Petros Atlanta, GA More articles by this author Usama Al-Qassab Atlanta, GA More articles by this author Chad Ritenour Atlanta, GA More articles by this author Muta Issa Atlanta, GA More articles by this author Daniel Canter Atlanta, GA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...