Clinical characteristics of bladder urothelial tumors in female patients.

Objective: The aim of this study was to investigate the influence of age and menopause on the clinical characteristics of bladder urothelial tumors in female patients. Methods: We retrospectively reviewed the clinical and pathological data of 215 consecutive female patients with bladder urothelial tumors who were treated at our department from January 2000 to July 2008. To investigate the relationship with age, the clinical characteristics of the patients were first classified into three groups: 50 years or younger, 51 to 69 years, and 70 years or older. Then, the women were classified into two groups: premenopausal and postmenopausal. The tumor characteristics of the two groups were analyzed to define the relationship, if any, with menopause. Furthermore, logistic regression model was constructed to discriminate variables (age and menopause). Results: The percentage of women with bladder urothelial carcinoma increased with increasing age, and a significant difference was observed among the three age groups (P = 0.003). Painless macroscopic hematuria occurred more frequently in the group of women 50 years or older at the first presentation (P = 0.003). On the other hand, compared with premenopausal women, postmenopausal women were more frequently diagnosed with bladder urothelial carcinoma and had a higher frequency of infiltrating carcinoma (P < 0.001 and P = 0.011, respectively). Logistic regression confirmed associations between menopause and tumor characteristics, controlling for age. Conclusions: Our study provided evidence that the natural history of bladder urothelial tumors seemed to differ according to menopause. It was observed that the percentage of bladder urothelial carcinomas increased with menopause. Moreover, there was a tendency for postmenopausal women to present with unfavorable infiltrating carcinoma more frequently.