The role of urine in a patient with a bladder neoplasm.

A review was done on reported cases of spontaneous regression of superficial bladder tumors in which cystectomy was preceded by bilateral ureterosigmoidostomy (the interval ranging from 21 days to 6 months). In every case in which the tumors were superficial complete disappearance of the papillary masses was observed by the naked eye and by microscopic examination. Tumor cells persisted in those cases in which the bladder wall was involved. I propose that the urine of the patient acts as a promoter to hyperplasia and neoplasia on foci of defective urothelial cells whose special coding apparatuses had been injured or destroyed by a carcinogen. The latter need no longer be present nor need there be exposure to co-carcinogen(s), such as is associated with excess alcohol intake or cigarette smoke inhalation. Tumor cells that were found in the excised bladder wall were cells that had become invasive (cancerous) and were no longer dependent.