Urethral slough: a rare and previously unreported complication of intravesical mitomycin.
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The natural history of superficial bladder carcinoma has an important bearing on the outcome of response to intravesical chemotherapy or immunotherapy. It may vary in different parts of the world, but it is essential that urologists know within their own practice how tumours respond to the initial transurethral resection. Many factors influence the natural history of superficial bladder carcinoma, and some, such as poor-grade, large tumour at presentation, smoking history, poor response to initial resection, and dysplasia or carcinoma in situ, should alert the urologist to introduce intravesical therapy at an early stage.
We report a case of calcification in the wall of the bladder following treatment of transitional cell carcinoma of the bladder with intravesical mitomycin C.
Long-term local BCG treatment of superficial bladder tumours is described and the 5-year results are reviewed. Complications of major significance in the course of immune therapy did not occur, loss due to death was not recorded. PPD skin test failed to furnish extra information regarding the biologic behaviour of the tumour. Annual repeats of the therapy promise better results than one single 6-week course.
A prophylaxis with a minidose of BCG Vaccine (1 mgr.) is performed in vesical instillation during one year, to 108 patients bearing bladder cancer in the stage T1. In the first month the instillations are once a week, each fifteen days the second and third month and then, once a month for one year. An 19.4% of recurrences is obtained with an general average observation time of 37.3 months as well as an important increase of muster populations of T lymphocytes and a positive test of dinitroclorobenzene. As complications we have obtained an inguinal BCG adenitis and in a few cases disury and frequency for two or three days. We conclude that the doses of the BCG vaccine used during the period of one year, is satisfactory in the reduction of recurrences and without important complications.
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