What is the Urothelium?

The urothelium is the bladder’s lining that also coats other parts of the urinary system, including the ureters. In most cases, people have two ureters—one tube that links the left kidney to the bladder and another that links the right kidney to the bladder. Urothelial cancer is a medical condition that can strike the urothelium. Bladder cancer is the most common form of urothelial cancer.

People with bladder cancer typically develop malignant tumors in the urothelial cells of the bladder wall. Three forms of cancer can develop in the bladder’s urothelium: transitional cell carcinoma, adenocarcinoma and squamous cell carcinoma. Transitional cell carcinomas usually develop in the innermost urothelium layer of the bladder wall, and this type of tumor may be flexible enough to stretch as the bladder empties or fills with urine. In many cases, an adenocarcinoma grows in glandular cells of the bladder’s urothelium that typically create mucous. Squamous cell carcinomas may develop in flat and thin squamous cells of the urothelium after irritation or an infection.

Urothelial cancer of the bladder is generally more likely to occur in people over 60 years of age. Men, tobacco users and individuals with a personal history of bladder infections may be at a greater risk of developing bladder cancer. Individuals who used a urinary catheter for a long period of time, people who underwent a kidney transplant and patients who were exposed to high levels of arsenic in their drinking water may also be more likely to get urothelial cancer of the bladder. Exposure to some industrial chemicals, such as those used in the production of dyes, textiles and rubber, can increase a person’s susceptibility to bladder cancer in some cases.

Doctors may use a thin tube with a light called a cystoscope to look through the urethra into the bladder and identify signs of cancer in the urothelium. Some physicians also use blood and urine tests to find signs of cancer. Patients with bladder cancer may experience frequent urination and may not being able to urinate when they feel bladder pressure. Bloody urine, lower back pain and pain during urination have been reported by some patients with urothelial cancer of the bladder.

Cancer of the bladder’s urothelium may be treated with several forms of cancer therapy, including surgical removal of a cancer tumor. Some surgeons use a cystoscope to burn away or remove a cancer tumor. Advanced bladder cancer cases may be treated with partial or total surgical removal of the bladder. Surgeons typically create a new means for urine to be expelled from a patient’s body after the entire bladder has been removed. Other treatments for urothelial cancer of the bladder may include chemotherapy or radiation therapy that kills cancer tumor cells.