HERALD LESION OF URINARY BLADDER* A Nonspecific but Significant Pathologic Process

Abstract Recurrent symptoms of acute or chronic cystitis may be due to an extravesical cancer or inflammatory process, clinically silent at the primary focus but encroaching on the bladder. The final stage is bladder perforation, evidenced by fecaluria or pneumaturia. Contributing most frequently to the genesis of a bladder herald lesion are perforating diverticulitis or cancer of the sigmoid colon or rectum; endometriosis or cancer of the cervix, uterus, or vagina; and subtrigonal prostatic cancer. The cystoscopic and microscopic appearance of the herald lesion in various stages is described, and case histories are presented.