Physical Exam

Physical exam findings and signs exhibited by patients with bladder cancer will vary according to the type of cancer. While the following may be observed, physical examination alone has a low sensitivity for detecting bladder cancer.

• Abdominal distention
• Abdominal tenderness
• Abdominal mass
• Organomegaly (for example, large liver and/or spleen)
• Palpable extension beyond bladder
• Fixation of bladder

Patients may also present with the following symptoms

• Hematuria (gross or microscopic)
• Sudden onset of gross painless hematuria
• Frequent urination
• Pain or burning during urination (dysuria)
• Urge to urinate even when bladder isn’t full (overactive bladder)
• Urinating often during the night (nocturia)

Other symptoms may occur as the bladder tumor grows larger

• Unable to urinate (urinary retention)
• Lower back pain on one side of the body
• Pain in the abdomen
• Bone pain or tenderness (bone is a common metastatic site)
• Unintended weight loss and loss of appetite
• Swelling in the feet (edema)
• Fatigue

Note: These symptoms could also be caused by urinary tract infections, kidney or bladder stones, or other problems related to the kidney.

Document physical exam details in NAACCR Item # 2520 Text-Dx Proc-PE.

See History & Physical Exam | SEER Training website for more information on the patient history and physical exam.

Updated: April 22, 2025