Efficacy of Postoperative Bladder Irrigation with Water for Injection in Reducing Recurrence Rates of Non Muscle Invasive Bladder Cancer

Grivas, Nikolaos; Hastazeris, K.; Kafarakis, Vasileios; Tsimaris, I.; Aspiotis, Spiridon; Stratis, Antonios; Stavropoulos, Nikolaos

doi:10.7314/apjcp.2014.15.5.2263

Cited by 10 publications

(11 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…study in terms of recurrence-free rates (55% and 61%, respectively) and recurrence-free interval (11 months and 15 months respectively). [9] In the present study, the number of patients with high-grade tumors was very small. Further, the complication rates in our study are similar to a study by Onishi et al .…”

Section: Discussionmentioning

confidence: 66%

“…have also shown that single and multiple bladder tumors receiving sterile water irrigation had a recurrence-free rate similar to those receiving immediate single dose of MMC. [9] In another study by Onishi et al ., the recurrence-free rate at the end of 1 year with continuous saline bladder irrigation ( n = 123) and intravesical instillation of MMC ( n = 115) after TUR were 76.7% and 81%, respectively, for patients with intermediate-risk NMIBC. They found no significant difference in the recurrence-free rate, the period to first recurrence and frequency of recurrence between the two groups.…”

Section: Discussionmentioning

confidence: 99%

“…[4567] Recently, sterile water has emerged as a valuable alternative. [8910111213] The majority of these studies have shown significant efficacy of sterile water in lysing tumor cells, where the cytotoxic effects are mainly caused by osmotic cytolysis. Initially, Price indicated that sterile water can be used for the irrigation of peritoneal cavity to destroy released cancer cells after surgery for several types of cancers.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of sterile water irrigation versus intravesical mitomycin C in preventing recurrence of nonmuscle invasive bladder cancer after transurethral resection

2017

View full text Add to dashboard Cite

Introduction:Early recurrence of nonmuscle invasive bladder cancer (NMIBC) following transurethral resection (TUR) remains relatively high. An immediate single instillation of mitomycin C (MMC) reduces the recurrence rates in the first 2 years but has not shown benefits in tumor progression or overall survival. Distilled water irrigation has shown to delay tumor recurrence by osmolysis of tumor cells. There are only limited clinical studies comparing the efficacy of MMC with continuous sterile water irrigation (CSWI) in preventing the recurrence of NMIBC after TUR in clinical setting.Materials and Methods:A prospective, randomized, open-label, two-arm, single-center, pilot study was conducted between December 2013 and September 2015 at a tertiary-care center in South India. Patients were randomized into CSWI group (n = 19) or single dose intravesical MMC group (n = 17) following TUR for NMIBC and analyzed. All patients were followed up with flexible cystoscopy and urine cytology at 3 months interval for 1 year. Recurrence-free rate was estimated as the primary criterion for outcome analysis.Results:At the end of 12 months, recurrence-free rates for MMC and CSWI groups were 47.1% and 52.6%, respectively. The mean recurrence-free interval for MMC and CSWI groups were 10.9 months and 9.8 months, respectively. The difference in recurrence-free rate or recurrence-free interval between two groups was statistically nonsignificant. Further, the complications in MMC group were significantly higher than that in CSWI group (P = 0.047).Conclusions:Continuous bladder irrigation with sterile water after TUR may be comparable to immediate single dose intravesical MMC in preventing tumor recurrence in NMIBC.

show abstract

Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of sterile water irrigation versus intravesical mitomycin C in preventing recurrence of nonmuscle invasive bladder cancer after transurethral resection

2017

View full text Add to dashboard Cite

show abstract

“…spillage [19]. Several trials evaluating the efficacy of hypotonic saline irrigation after TURBT on bladder cancer recurrence showed promising results but these trials were small or retrospective, and so the treatment has not been accepted as a mainstream option [20][21][22]. One trial reported that continuous irrigation with hypotonic saline caused transient and clinically insignificant hyperkalemia, a result that might hint that continuous exposure to hypotonic saline leads to its absorption and results in hemolysis.…”

Section: Resultsmentioning

confidence: 99%

Single Instillation of Hypertonic Saline Immediately Following Transurethral Resection of Bladder Tumor for Recurrence Prevention –A Phase I Study

Modai

Kovalyonok

Scherz

et al. 2021

BLC

View full text Add to dashboard Cite

BACKGROUND: Urologic guidelines recommend perioperative instillation of chemotherapy after transurethral resection of bladder tumor (TURBT) to decrease tumor recurrence, yet implementation of this recommendation is partial due to associated morbidity. Hypertonic saline destroys cells by osmotic dehydration and might present a safer alternative. OBJECTIVE: To evaluate the safety of 3% hypertonic saline (Hypersal) intravesical instillation following TURBT in rats and in humans. METHODS: In 8 rats whose bladders were electrically injured, intravesical blue-dyed Hypersal was administered. We measured serum sodium levels before and after instillation and pathologically evaluated their pelvic cavity for signs of inflammation or blue discoloration. Twenty-four patients were recruited to the human trial (NIH-NCT04147182), 15 comprised the interventional and 10 the control group (one patient crossed over). Hypersal was given postoperatively. Serum sodium was measured before, 1 hour and 12–24 hours after instillation. Adverse effects were documented and compared between the groups. RESULTS: In rats, average sodium levels were 140.0 mEq/L and 140.3 mEq/L before and following instillation, respectively. Necropsy revealed no signs of inflammation or blue discoloration. In humans the average plasma sodium levels were 138.6 mEq∖L, 138.8 mEq∖L and 137.7 mEq∖L before, 1 hour and 12–24 hours after instillation, respectively. During the postoperative follow-up there was one case of fever. A month after the surgery, dysuria was reported by 5 patients while urgency and hematuria were reported by one patient each. The most severe adverse events were grade 2 on the Clavien-Dindo scale. Adverse events were similar in the control group. CONCLUSIONS: Hypersal instillation is safe and tolerable immediately after TURBT.

show abstract

“…9 In addition, it was reported that the bladder irrigation with sterile water after transurethral resection reduced recurrence rates of non-muscle-invasive bladder cancer. 10,11 While the effect of intraperitoneal lavage with sterile water has been studied in colorectal 12 and ovarian cancer, 13 data are lacking in bladder cancer literature in regards to optimal duration of sterile water exposure. We investigated the effect of water on bladder cancer cells by analyzing changes in cellular morphology, viability, membrane integrity, and DNA fragmentation at varying time points of water exposure.…”

Section: Introductionmentioning

confidence: 99%

In-vitro cytocidal effect of water on bladder cancer cells: The potential role for intraperitoneal lavage during radical cystectomy

Taoka

Williams²,

Ho³

et al. 2015

CUAJ

View full text Add to dashboard Cite

show abstract

Efficacy of Postoperative Bladder Irrigation with Water for Injection in Reducing Recurrence Rates of Non Muscle Invasive Bladder Cancer

Cited by 10 publications

References 30 publications

Comparison of sterile water irrigation versus intravesical mitomycin C in preventing recurrence of nonmuscle invasive bladder cancer after transurethral resection

Comparison of sterile water irrigation versus intravesical mitomycin C in preventing recurrence of nonmuscle invasive bladder cancer after transurethral resection

Single Instillation of Hypertonic Saline Immediately Following Transurethral Resection of Bladder Tumor for Recurrence Prevention –A Phase I Study

In-vitro cytocidal effect of water on bladder cancer cells: The potential role for intraperitoneal lavage during radical cystectomy

Contact Info

Product

Resources

About