Frequently, the patient harboring a bladder tumor experiences an early transient episode of gross hematuria which if unheeded may result in a dangerous delay in diagnosis. Such bleeding may occur from the indirect stimulation of a vesical neoplasm during certain procedures such as abdominal palpation, digital rectal examination, and proctoscopic examination. Only careful history-taking for the presence of postexamination hematuria will lead to the early detection of the hitherto silent neoplasm of the bladder.
Furlow WL, Mussey E. The "Silent" Vesical Neoplasm. JAMA. 1968;204(1):76–77. doi:10.1001/jama.1968.03140140078023
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