Prostate Cancer Diagnosis and Treatment for Patients with Neurogenic Bladder: Does the Literature Support a Different Approach?

In this review, the current literature available to patients and providers on the diagnosis and management of prostate cancer in patients with neurogenic bladder will be discussed. Topics include prostate cancer screening and diagnosis, radical prostatectomy and radiotherapy for prostate cancer, as well as surveillance.

Neurogenic lower urinary tract dysfunction (NLUTD) patients are living longer due to better care, and cancer is becoming more frequent. This is partly due to the aging of this population, as well as intrinsic factors related to the underlying condition or urinary diversion, which poses them a greater risk of developing genitourinary malignancies. Although multiple studies have investigated this patient population, most are derived from large cohorts of spinal cord injury patients.

Many studies reported how PSA changes for different NGB patients. Few studies have investigated the management of prostate cancer, and good quality evidence for tailoring the care of this population is lacking. Although more evidence is available, improvement is still needed in using biomarkers for early diagnosis, specific screening protocols for different underlying conditions and urinary diversion, and standardized treatment recommendations based on long-term follow-up and surveillance.