Refractory Bladder Neck Contracture managed by Combination of Bladder Neck Resection with Ten Point Intralesional Mitomycin C Injection in Post TURP Status: A 3-Years Single-Center Experience
BAUS ePoster online library. Selvaraj N. 06/21/21; 319076; p3-8
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Mr. Nivash Selvaraj
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Abstract
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Introduction:
Bladder neck contracture (BNC) is an annoying problem for patients and urologists. Recurrence still remains to be a common problem and associated with significant morbidity. This study evaluated the efficacy and side effects of mitomycin C (MMC) which has anti-collagen and anti-fibroblast properties in the prevention of BNC recurrence after transurethral bladder neck resection (TUBNR).
Materials and Methods:
23 patients between March 2017 and April 2019 with persistent BNCs who underwent failed endoscopic procedures (≥ 3 times) were evaluated by using International Prostate Symptom Score (IPPS), uroflowmetry, quality of life (QOL) and post void residual urine (PVR) preoperatively. All patients underwent TUBNR followed by ten-point intraoperative MMC injection, not exceeding a total dose of 2 mg (0.2 mg/mL), which was given circumferentially at the resected site, using Williams cystoscopic needle (Figure 1). Patients were reviewed at 3 months, 6 months, 1 year, 2 years and 3 years postoperatively.
Results:
The median patient age was 66 years. The mean follow-up was 36 months. Overall 91% (21 of 23) of patients demonstrated resolution of BNCs and sufficient flow rate which was evaluated by uroflowmetry, PVR, IPPS and QoL postoperatively. One patient had detrusor underactivity. Relapse was seen in two patients. No patients experienced adverse effects related to MMC.
Conclusions:
Ten-site injection of MMC after TUBNR can be considered as a efficient and safe technique with no major adverse event.
Bladder neck contracture (BNC) is an annoying problem for patients and urologists. Recurrence still remains to be a common problem and associated with significant morbidity. This study evaluated the efficacy and side effects of mitomycin C (MMC) which has anti-collagen and anti-fibroblast properties in the prevention of BNC recurrence after transurethral bladder neck resection (TUBNR).
Materials and Methods:
23 patients between March 2017 and April 2019 with persistent BNCs who underwent failed endoscopic procedures (≥ 3 times) were evaluated by using International Prostate Symptom Score (IPPS), uroflowmetry, quality of life (QOL) and post void residual urine (PVR) preoperatively. All patients underwent TUBNR followed by ten-point intraoperative MMC injection, not exceeding a total dose of 2 mg (0.2 mg/mL), which was given circumferentially at the resected site, using Williams cystoscopic needle (Figure 1). Patients were reviewed at 3 months, 6 months, 1 year, 2 years and 3 years postoperatively.
Results:
The median patient age was 66 years. The mean follow-up was 36 months. Overall 91% (21 of 23) of patients demonstrated resolution of BNCs and sufficient flow rate which was evaluated by uroflowmetry, PVR, IPPS and QoL postoperatively. One patient had detrusor underactivity. Relapse was seen in two patients. No patients experienced adverse effects related to MMC.
Conclusions:
Ten-site injection of MMC after TUBNR can be considered as a efficient and safe technique with no major adverse event.
Introduction:
Bladder neck contracture (BNC) is an annoying problem for patients and urologists. Recurrence still remains to be a common problem and associated with significant morbidity. This study evaluated the efficacy and side effects of mitomycin C (MMC) which has anti-collagen and anti-fibroblast properties in the prevention of BNC recurrence after transurethral bladder neck resection (TUBNR).
Materials and Methods:
23 patients between March 2017 and April 2019 with persistent BNCs who underwent failed endoscopic procedures (≥ 3 times) were evaluated by using International Prostate Symptom Score (IPPS), uroflowmetry, quality of life (QOL) and post void residual urine (PVR) preoperatively. All patients underwent TUBNR followed by ten-point intraoperative MMC injection, not exceeding a total dose of 2 mg (0.2 mg/mL), which was given circumferentially at the resected site, using Williams cystoscopic needle (Figure 1). Patients were reviewed at 3 months, 6 months, 1 year, 2 years and 3 years postoperatively.
Results:
The median patient age was 66 years. The mean follow-up was 36 months. Overall 91% (21 of 23) of patients demonstrated resolution of BNCs and sufficient flow rate which was evaluated by uroflowmetry, PVR, IPPS and QoL postoperatively. One patient had detrusor underactivity. Relapse was seen in two patients. No patients experienced adverse effects related to MMC.
Conclusions:
Ten-site injection of MMC after TUBNR can be considered as a efficient and safe technique with no major adverse event.
Bladder neck contracture (BNC) is an annoying problem for patients and urologists. Recurrence still remains to be a common problem and associated with significant morbidity. This study evaluated the efficacy and side effects of mitomycin C (MMC) which has anti-collagen and anti-fibroblast properties in the prevention of BNC recurrence after transurethral bladder neck resection (TUBNR).
Materials and Methods:
23 patients between March 2017 and April 2019 with persistent BNCs who underwent failed endoscopic procedures (≥ 3 times) were evaluated by using International Prostate Symptom Score (IPPS), uroflowmetry, quality of life (QOL) and post void residual urine (PVR) preoperatively. All patients underwent TUBNR followed by ten-point intraoperative MMC injection, not exceeding a total dose of 2 mg (0.2 mg/mL), which was given circumferentially at the resected site, using Williams cystoscopic needle (Figure 1). Patients were reviewed at 3 months, 6 months, 1 year, 2 years and 3 years postoperatively.
Results:
The median patient age was 66 years. The mean follow-up was 36 months. Overall 91% (21 of 23) of patients demonstrated resolution of BNCs and sufficient flow rate which was evaluated by uroflowmetry, PVR, IPPS and QoL postoperatively. One patient had detrusor underactivity. Relapse was seen in two patients. No patients experienced adverse effects related to MMC.
Conclusions:
Ten-site injection of MMC after TUBNR can be considered as a efficient and safe technique with no major adverse event.
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