Background: Traumatic spinal cord injury (SCI) is also a combat-related injury that is increasing in modern warfare. The aim of this work is to inform medical experts regarding the different course of bladder cancer in able-bodied patients compared with SCI patients based on the latest medical scientific knowledge, and to present decision-making aids for the assessment of bladder cancer as a late sequela of traumatic SCI. Methods: A study conducted between January 1998 and December 2019 in the BG Trauma Hospital Hamburg formed the basis for the decision-making aids. Urinary bladder cancer was diagnosed in 40 out of 7396 treated outpatient and inpatient SCI patients. General patient information, latency period, age at initial diagnosis, type of bladder management and survival of SCI patients with bladder cancer were collected and analysed. T category, grading and tumor entity in these patients were compared with those in the general population. Relevant bladder cancer risk factors in SCI patients were analysed. Furthermore, relevant published literature was taken into consideration. Results: Initial diagnosis of urinary bladder cancer in SCI patients occurs at a mean age of 56.4 years (SD ± 10.7 years), i.e., approximately 20 years earlier as compared with the general population. These bladder cancers are significantly more frequently muscle invasive (i.e., T category ≥T2) and present a higher grade at initial diagnosis. Furthermore, SCI patients show a significantly higher proportion of the more aggressive squamous cell carcinoma than that of the general population in areas not endemic for the tropical disease schistosomiasis. Consequently, the survival time is extremely unfavourable. A very important finding, for practical reasons is that, in the Hamburg study as well as in the literature, urinary bladder cancer is more frequently observed after 10 years or more of SCI. Based on these findings, a matrix was compiled where the various influencing factors, either for or against the recognition of an association between SCI and urinary bladder cancer, were weighted according to their relevance. Conclusions: The results showed that urinary bladder cancer in SCI patients differs considerably from that in ablebodied patients. The presented algorithm is an important aid in everyday clinical practice for assessing the correlation between SCI and bladder cancer.

Ralf Böthig;Christian Tiburtius;Wolfgang Schöps;Michael Zellner;Oliver Balzer;Birgitt Kowald;Sven Hirschfeld;Roland Thietje;Aki Pietsch;Ines Kurze;Martin Forchert;Thura Kadhum;Klaus Golka

Department of Neuro-Urology,Centre for Spinal Cord Injuries,BG Klinikum Hamburg,21033 Hamburg,Germany;Urological Practice,53757 Sankt Augustin,Germany;Department of Urology and Neuro-Urology,Johannesbad Fachklinik,94072 Bad Füssing,Germany;Biomechanical Laboratory,Centre for Spinal Cord Injuries,BG Klinikum Hamburg,21033 Hamburg,Germany;Centre for Spinal Cord Injuries,BG Klinikum Hamburg,21033 Hamburg,Germany;Department of Sports and Rehabilitation Medicine,BG Klinikum Hamburg,21033 Hamburg,Germany;Department of Paraplegiology and Neuro-Urology,Centre for Spinal Cord Injuries,Zentralklinik Bad Berka,99437 Bad Berka,Germany;Staff Position Accident Insurance Law,Statutory Accident Insurance for Wood and Metal(BGHM),33602 Bielefeld,Germany;Department of Psychosomatic Rehabilitation,Mittelrheinklinik Fachklinik,56154 Boppard-Bad Salzig,Germany;Clinical Occupational Medicine,Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund(IfADo),44139 Dortmund,Germany

军事医学研究（英文）

[1]Ralf Böthig;Christian Tiburtius;Wolfgang Schöps;Michael Zellner;Oliver Balzer;Birgitt Kowald;Sven Hirschfeld;Roland Thietje;Aki Pietsch;Ines Kurze;Martin Forchert;Thura Kadhum;Klaus Golka-.Urinary bladder cancer as a late sequela of traumatic spinal cord injury)[J].军事医学研究（英文）,2022(01):21-31

ablebodied

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