Efficacy of continuous bladder irrigation with saline after transurethral resection of nonmuscle-invasive bladder cancer stage Ta T1 to prevent cancer recurrence and progression in comparison with a single immediate instillation of mitomycin C chemotherapeutic

Wishahi, Mohamed; Nour, Hani; Elesaily, Khaled; Mehena, Ahmed

doi:10.4103/ejs.ejs_317_20

Efficacy of continuous bladder irrigation with saline after transurethral resection of nonmuscle-invasive bladder cancer stage Ta T1 to prevent cancer recurrence and progression in comparison with a single immediate instillation of mitomycin C chemotherapeutic

Authors

Abstract

Background
Continuous bladder irrigation (CBI) following transurethral resection of bladder tumor is a common practice, which usually continues in the early postoperative period. This irrigation may help to prevent tumor cell seeding, which is one of the precursors of tumor recurrence.
Aim
In our study, we investigated the efficacy and safety of CBI against the standard single post-tumor-resection installation of mitomycin C (MMC).
Patients and methods
An observational study was conducted for evaluation of patients admitted with bladder mass to our Urology Department. A total of 63 patients had single MMC instillation, whereas 73 had CBI with saline. Only patients with longer than 24 months of follow-up were analyzed.
Results
Overall complications were comparable in both arms except the need to administrate anticholinergic drugs for persistent irritative urinary symptoms in the MMC arm. Time to recurrence was shorter in CBI with saline arm, yet with no effect on recurrence incidence rate, nor the time to progression.
Conclusion
CBI with saline shows noninferior results to single postoperative adjuvant installation of MMC in terms of recurrence and progression with better tolerability.

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