Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with gross hematuria, frequency, urgency, and dysuria. Significant history of tobacco use. No flank pain or constitutional symptoms (weight loss, night sweats). Previous TURBT pathology confirmed high-grade urothelial carcinoma with muscularis propria invasion (cT2).
Clinical Examination Findings
Abdomen: Soft, non-tender, no palpable masses or bladder distension. External genitalia: Normal. DRE: No palpable prostatic induration or pelvic mass. Lymph nodes: No palpable inguinal or supraclavicular lymphadenopathy. Performance status: ECOG [0-1].
Treatment Protocol
Plan: Neoadjuvant cisplatin-based chemotherapy (NAC) followed by radical cystectomy with pelvic lymph node dissection and urinary diversion (ileal conduit vs. neobladder). Pre-operative staging CT chest/abdomen/pelvis completed. Nutritional optimization and smoking cessation counseling initiated.