Incidental bladder cancer at initial urological workup of spinal cord injury patients


Study design

Retrospective descriptive study.


To compare histopathological findings and the long-term course of SCI patients with bladder cancer found incidentally at the initial urological workup to those diagnosed with bladder cancer many years after the onset of SCI.


Spinal cord injury center in Germany.


Data and follow-up of consecutive in- and out-patients with SCI admitted at a tertiary spinal cord injury center between January 1, 1998 and December 31, 2018 were screened retrospectively. All patients with acquired SCI were evaluated for pathological findings in the urinary bladder present at the time of SCI on the initial urological workup. Data of 37 long-term SCI patients from the same center with diagnosed bladder cancer and data of the general German population served as reference groups. Descriptive statistics were applied.


In total, four patients with bladder cancer at initial urological workup were assessed. They all had non-muscle invasive bladder cancer. Two of the patients were cystectomized 34 and 106 months after first bladder cancer diagnosis, due to relapsing tumor and progressive renal failure, respectively. In both cases no tumor was found in the resected bladder. All four patients are currently alive with no tumor and a mean follow-up of 105 months.


In incidental bladder cancer observed at the initial urological workup after acquired SCI, the duration of SCI, at least in the first 5 years, does not noticeably contribute to a poor prognosis, i.e., progression to muscle invasive bladder cancer (≥T2) or a higher grading (G3).

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Fig. 1: T category and grading in three different groups of bladder cancer patients.
Fig. 2: Kaplan–Meier curves of three different groups of bladder cancer patients.
Fig. 3: Kaplan–Meier curves of three different groups of cystectomized patients.

Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.


  1. 1.

    Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424.

    Article  Google Scholar 

  2. 2.

    Ismail S, Karsenty G, Chartier-Kastler E, Cussenot O, Compérat E, Rouprêt M, et al. Prevalence, management, and prognosis of bladder cancer in patients with neurogenic bladder: a systematic review. Neurourol Urodyn. 2018;37:1386–95.

    Article  Google Scholar 

  3. 3.

    Gui-Zhong L, Li-Bo M. Bladder cancer in individuals with spinal cord injuries: a meta-analysis. Spinal Cord. 2017;55:341–5.

    CAS  Article  Google Scholar 

  4. 4.

    Groah SL, Weitzenkamp DA, Lammertse DP, Whiteneck GG, Lezotte DC, Hamman RF. Excess risk of bladder cancer in spinal cord injury: evidence for an association between indwelling catheter use and bladder cancer. Arch Phys Med Rehab. 2002;83:346–51.

    Article  Google Scholar 

  5. 5.

    Nahm LS, Chen Y, DeVivo MJ, Lloyd LK. Bladder cancer mortality after spinal cord injury over 4 decades. J Urol. 2015;193:1923–8.

    Article  Google Scholar 

  6. 6.

    Böthig R, Tiburtius C, Fiebag K, Kowald B, Hirschfeld S, Thietje R, et al. Traumatic spinal cord injury confers bladder cancer risk to patients managed without permanent urinary catheterization: lessons from a comparison of clinical data with the national database. World J Urol. 2020.

  7. 7.

    Manach Q, Cussenot O, Rouprêt M, Gamé X, Chartier-Kastler E, Reus C, et al. Analysis of bladder cancer subtypes in neurogenic bladder tumors. Can J Urol. 2018;25:9161–7.

    PubMed  Google Scholar 

  8. 8.

    Welk B, McIntyre A, Teasell R, Potter P, Loh E. Bladder cancer in individuals with spinal cord injuries. Spinal Cord. 2013;51:516–21.

    CAS  Article  Google Scholar 

  9. 9.

    Elliott SP. Screening for bladder cancer in individuals with spinal cord injury. J Urol. 2015;193:1880–1.

    Article  Google Scholar 

  10. 10.

    Cameron AP, Rodriguez GM, Schomer KG. Systematic review of urological followup after spinal cord injury. J Urol. 2012;187:391–7.

    Article  Google Scholar 

  11. 11.

    Cancer Research UK. 2018a. Accessed 6 June 2020.

  12. 12.

    Cancer Research UK. 2018b. Accessed 6 June 2020.

  13. 13.

    Rove KO, Husmann DA, Wilcox DT, Vricella GJ, Higuchi TT. Systematic review of bladder cancer outcomes in patients with spina bifida. J Pediatr Urol. 2017;13:456.e1–9.

    CAS  Article  Google Scholar 

  14. 14.

    Meléndez M, Maroto A, Illescas T, Allué M, Castro L, Carreras E, et al. Bladder cancer in patients with spina bifida: observation from an adult clinic. Spinal Cord SerCases. 2018;4.

  15. 15.

    Stonehill WH, Dmochowski RR, Patterson AL, Cox CE. Risk factors for bladder tumors in spinal cord injury patients. J Urol. 1996;155:1248–50.

    CAS  Article  Google Scholar 

  16. 16.

    Vereczkey ZA, Schmeidler J, Binard JE, Bauman WA. Bladder cancer risk in patients with spinal cord injury. J Spinal Cord Med. 1998;21:230–9.

    CAS  Article  Google Scholar 

  17. 17.

    West DA, Cummings JM, Longo WE, Virgo KS, Johnson FE, Parra RO. Role of chronic catheterization in the development of bladder cancer in patients with spinal cord injury. Urology. 1999;53:292–7.

    CAS  Article  Google Scholar 

  18. 18.

    Pannek J. Transitional cell carcinoma in patients with spinal cord injury: a high risk malignancy? Urology. 2002;59:240–4.

    Article  Google Scholar 

  19. 19.

    Hess MJ, Zhan EH, Foo DK, Yalla SV. Bladder cancer in patients with spinal cord injury. J Spinal Cord Med. 2003;26:335–8.

    Article  Google Scholar 

  20. 20.

    Kalisvaart JF, Katsumi HK, Ronningen LD, Hovey RM. Bladder cancer in spinal cord injury patients. Spinal Cord. 2010;48:257–61.

    CAS  Article  Google Scholar 

Download references


We thank Dr. Kraywinkel, Robert Koch Institute, Berlin, Germany, for providing the bladder cancer data in the general population in Germany.

Author information



Corresponding author

Correspondence to Ralf Böthig.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Böthig, R., Golka, K., Tiburtius, C. et al. Incidental bladder cancer at initial urological workup of spinal cord injury patients. Spinal Cord Ser Cases 6, 55 (2020).

Download citation