Bladder paraganglioma: a 25-year systematic review unveils the benefits of early diagnosis in reducing surgical complications.

Background: Bladder paraganglioma (BPG) is a rare tumor frequently misdiagnosed before surgery. To raise awareness and improve early detection, we systematically reviewed clinical manifestations and treatment approaches reported in BPG case reports over the past 25 years. We aimed to identify factors that could facilitate timely diagnosis and reduce complications from misdiagnosis. Materials and methods: We searched PubMed for BPG case reports published between January 1, 2000, and December 31, 2024. Two independent reviewers extracted data and performed statistical analyses. Patients were categorized into two groups based on preoperative diagnosis: correctly diagnosed and misdiagnosed. Results: A total of 199 cases from 184 articles were included, with eighty patients (40.2%) preoperatively diagnosed with BPG and 119 (59.8%) misdiagnosed. Catecholamine-related symptoms were significantly more common in the correctly diagnosed group (60.0% vs. 21.8%, Conclusion: More than half of BPG patients lack accurate preoperative diagnoses. Catecholamine-related symptoms were strongly associated with correct diagnosis, while urinary symptoms increased misdiagnosis. Patients with preoperative correct diagnosis more frequently received