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

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 <i>α</i>-adrenergic blockade and underwent cystectomy rather than transurethral resection, with reduced hypertensive crises, surgery discontinuation, and residual tumors compared with those misdiagnosed. These findings highlight the need for structured catecholamine screening in bladder mass diagnostics and support our diagnostic flowchart to enhance early BPG detection.