Renal cell carcinoma: a preliminary clinical trial of methodichlorophen (D.D.M.P.).
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Biomedical subjects
Publications and source records attributed to J R Hindmarsh.
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Over the last 8 years 64 cases of bladder hyperactivity have been subjected to bladder transection. The patients seleced have been mainly adult enuretics, but have also included some others with daytime bladder hyperactivity without nocturnal incontinence who had failed to respond to medical and simple surgical procedures. A bladder capacity greater than 400 ml under general anaesthesia was used as a major criterion in selecting the cases for operation. The operation was very successful in the enuretic syndrome where the daytime symptoms or urgency and urge incontinence were severe. Other patients who had frequency, urgency and urge incontinence without demonstrable neurological or urological abnormalities also responded well.
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45 patients with adult enuresis have been treated by bladder transection between 1969 and 1975 and followed-up from 6 months to 7 years. 24 patients are now asymptomatic. Bladder transection gave very worthwhile results in 53% of cases.
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High temperature bladder irrigation was employed in 4 men as an alternative to cystectomy because of their age and frailty. Hyperthermic irrigation of the bladder from 63 degree C for 70 minutes to 82 degree C for 25 minutes caused partial, but not total, necrosis of the bladder. Transitional cell carcinoma appears to be resistant in vivo, in some cases, to heating at temperatures that destroy adjacent normal structures. Hyperthermic irrigation of the bladder at these high temperatures may be hazardous. In view of these findings we cannot recommend high temperature bladder irrigation as an alternative to cystectomy even in poor risk patients.