膀胱原位癌、腺性膀胱炎误诊为慢性前列腺疾病原因分析  

Causes of Misdiagnosis of Carcinoma in Situ of the Bladder and Glandular Cystitis as Chronic Prostatic Diseases

作　　者：王嘉影 田茂 WANG Jiaying;TIAN Mao(Department of General Medicine,Weihai Central Hospital,Weihai,Shandong 264400,China;Department of Urinary Surgery,People's Hospital of Wendeng District,Weihai,Shandong 264499,China)

机构地区：[1]威海市中心医院全科医学科,山东威海264400 [2]威海市文登区人民医院泌尿外科,山东威海264499

出　　处：《临床误诊误治》2025年第5期26-31,共6页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨膀胱原位癌、腺性膀胱炎误诊为慢性前列腺疾病的原因及预防措施。方法回顾分析2018至2022年收治的膀胱原位癌、腺性膀胱炎误诊为慢性前列腺疾病2例的临床资料。结果1例表现为尿频、尿急、尿痛6个月,血尿3个月;另1例表现为尿频、排尿困难3年余。1例误诊为慢性前列腺炎,误诊时间6个月;另1例误诊为前列腺增生,误诊时间3年余。最后均经病理检查确诊。1例在全麻下行腹腔镜膀胱癌根治性切除+乙状结肠原位膀胱术,术后病理诊断为膀胱原位癌,术后4年肿瘤复发转移行放化疗,最终死亡;另1例在硬膜外麻醉下行经尿道膀胱占位性病变切除术,术后病理诊断为腺性膀胱炎,术后随访3年余,未再复发。结论膀胱原位癌、腺性膀胱炎临床表现无特异性症状,均可表现为尿频、尿急、尿痛等膀胱刺激症状,也可表现为排尿困难、血尿、会阴坠胀痛等前列腺疾病症状,病程较长者容易误诊为前列腺疾病;临床医师应提高对膀胱肿瘤的认识与警惕性,避免误漏诊的发生。Objective To investigate the causes and preventive measures of misdiagnosis of carcinoma in situ(CIS)of the bladder and glandular cystitis as chronic prostate diseases.Methods The clinical data of 2 patients with CIS of the bladder and glandular cystitis misdiagnosed with chronic prostate diseases from 2018 to 2022 were retrospectively analyzed.Results One patient presented with frequent,urgent,and painful urination for 6 months and hematuria for 3 months.The other patient presented with frequent urination and dysuria for more than 3 years.One patient was misdiagnosed as chronic prostatitis,and the misdiagnosis lasted 6 months.The other patient was misdiagnosed as prostatic hyperplasia,and the misdiagnosis lasted more than 3 years.The disease in both patients were pathologically confirmed.One patient underwent radical laparoscopic resection of bladder cancer under general anesthesia plus sigmoid in situ bladder surgery,and was pathologically diagnosed as CIS of the bladder.The tumor recurred and metastasized at 4 years after surgery,and the patient finally died.The other patient underwent transurethral resection of bladder space-occupying lesions under epidural anesthesia,and was pathologically diagnosed as glandular cystitis.No recurrence occurred at 3-year follow-up after surgery.Conclusion The clinical manifestations of CIS of the bladder and glandular cystitis have no specific symptoms,which can be manifested as bladder irritation such as frequent,urgent,and painful urination,or as prostatic diseases such as dysuria,hematuria and distending pain in the perineum.Patients with a longer course of illness are more likely to be misdiagnosed with prostate diseases.Clinicians should enhance the awa.reness and vigilance of bladder tumors to avoid the occurrence of misdiagnosis.

关 键 词：膀胱肿瘤 腺性膀胱炎 误诊 前列腺疾病 泌尿系感染 前列腺增生 前列腺炎 

分 类 号：R737.14[医药卫生—肿瘤]