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At least 685 records · Page 38Linked to original sources
PubMed2003

Over expression of metallothionein predicts resistance of transitional cell carcinoma of bladder to intravesical mitomycin therapy.

PURPOSE: Metallothionein, a low molecular weight intracellular protein, binds mitomycin with high affinity protecting the tumor DNA. We prospectively studied the relationship of metallothionein expression in bladder transitional cell carcinoma and resistance to intravesical mitomycin. MATERIALS AND METHODS: A series of 45 consecutive patients with superficial transitional cell carcinoma treated with intravesical mitomycin were studied. Resected tumor tissues were stained with metallothionein monoclonal antibody E9. Two pathologists scored staining intensity and distribution. All patients were followed with regular flexible cystoscopy. RESULTS: Median patient age was 73 years (range 44 to 89). Tumor grade was 1 to 3 in 6, 33 and 6 cases, respectively. In 20 patients (44.44%) tumor recurred after mitomycin therapy. Median cytoplasmic staining scores for recurrent and nonrecurrent tumors were 5 (range 0 to 61) and 0 (0 to 14), respectively. Median nuclear staining scores for recurrent and nonrecurrent tumors were 3 (range 0 to 56) and 0 (0 to 11), respectively. Median followup of patients without recurrence was 18 months (range 12 to 36). Nuclear and cytoplasmic staining scores were significantly higher in recurrent than in nonrecurrent tumors. There was no significant relationship of metallothionein expression with tumor grade. CONCLUSIONS: Over expression of metallothionein predicts the resistance of bladder transitional cell carcinoma to intravesical mitomycin therapy.

Administration, Intravesical↗
PubMed1997

Immunohistochemical study of tumor-infiltrating lymphocytes before and after intravesical bacillus Calmette-Guérin treatment for superficial bladder cancer.

BACKGROUND: This study investigated changes in the phenotypic characteristics of tumor-infiltrating lymphocytes during intravesical bacillus Calmette-Guérin (BCG) treatment using an immunohistochemical technique. METHODS: A total of 16 patients with superficial bladder cancer underwent intravesical BCG treatment for therapeutic purposes. Tissue specimens were obtained from these patients before and after BCG treatment by cold cup biopsies. RESULTS: The numbers of CD3+ cells, CD4+ cells, CD8+ cells, and CD19+ cells significantly increased after treatment compared with numbers before treatment (P < 0.01). Although gamma/delta T cells were not observed before treatment, they appeared after treatment in 6 patients. In all these patients, the tumors disappeared or their size was reduced by more than 50%, and none of the tumors recurred. The induction of CD25+ cells after treatment was seen in 11 of the 16 patients. CONCLUSION: gamma/delta T cells may play an important role in the immune response of the host to the tumor in intravesical BCG treatment (although this correlation was statistically insignificant.

Adjuvants, Immunologic↗
PubMed1993

Use of maintenance intravesical bacillus Calmette-Guérin (BCG), with or without intradermal BCG, in patients with recurrent superficial bladder cancer. Long-term follow-up of a randomized phase 2 study.

To study maintenance Bacillus Calmette-Guérin (BCG) therapy we treated 49 patients with recurrent superficial bladder cancer pTa and/or carcinoma in situ, failing previous intravesical chemotherapy. They received 20 intravesical instillations in 1 year, with or without 6 intradermal inoculations. Side effects were frequent, causing treatment stop in 14 patients (29%). Drug-induced cystitis was the most frequent side effect, seen in 29 patients (59%). Forty-two patients were evaluable for response. During the first 2 years of the study 14 patients (33%) had one (n = 8) or more (n = 6) recurrences. A total of 18 patients (43%) remained recurrence free with a median follow-up of 47 months. Progression was seen in 2 patients from pTa to pT1, another patient died of metastatic bladder cancer after 47 months. PPD skin test conversion was of no prognostic value. The use of intradermal inoculations caused no significant increase of toxicity and had no effect on efficacy, however, both groups were small. It caused no local side effects. We conclude that maintenance BCG therapy can be useful for patients with recurrent superficial bladder cancer failing previous intravesical chemotherapy.

Administration, Cutaneous↗
PubMed1993

Effects of intravesically administered anticholinergics, beta-adrenergic stimulant and alpha-adrenergic blocker on bladder function in unanesthetized rats.

Comparative analysis of the effects of intravesical instillation of drugs on urodynamic parameters (MVP, maximum intravesical pressure; RR, residual rate; BC, bladder capacity) was performed using an experimental model in unanesthetized rats. The drugs investigated in this study were atropine (7.2 x 10(-4)-7.2 x 10(-2) M), propantheline (7.2 x 10(-3)-2.2 x 10(-2) M), oxybutynin (2.5 x 10(-3)-2.5 x 10(-2) M), isoproterenol (5 x 10(-2)-10(-1) M) and prazosin (5 x 10(-4) M). Of the anticholinergics, propantheline and oxybutynin showed a remarkable suppression of MVP accompanied with a consistent increase of RR and BC in a dose-dependent manner. Atropine showed, however, no suppression of MVP in spite of a significant change of RR and BC. Isoproterenol suppressed MVP with an increase of RR and BC in a dose-dependent manner at a relatively high concentration. Prazosin increased BC and RR at a relatively low concentration. This study revealed that these intravesical drugs have the ability to suppress spontaneous bladder contraction in unanesthetized rats and to change the micturition function in the urinary filling and storage phases. It is expected that intravesical instillation therapy for detrusor hyperreflexia will be improved in the future based upon the data obtained.

Administration, Intravesical↗
PubMed1999

[A case of transitional cell carcinoma of the bladder in a juvenile patient].

A case of transitional cell carcinoma of the bladder in a 18-year-old female is presented. Cystoscopic examination revealed a papillary tumor on the left lateral wall. Histopathology of the excised tumor showed transitional cell carcinoma, G1 > 2, pT1a. Recurrence has not been observed for about 1 year, after intravesical pirarubicin therapy.

Administration, Intravesical↗
PubMed1999

[Intravesical drug therapy in women with severe urge incontinence. Clinical experiences from a department of gynecology].

Conventional oral pharmacotherapy for urge incontinence remains problematic because of limited efficacy and systemic side effects. In this study 27 patients with severe urge incontinence were treated with intravesical drugs (emepron 200 mg or oxybutynin 5 mg) twice a day. They had previously on average undergone 3.3 other treatment options without satisfactory effect. The average age was 62 years, and their incontinence had on average lasted for 15 years. Seven percent were cured and 41% were improved. Fifty-two percent had no satisfactory effect of the treatment. The number of side effects was low, and none left the study for this reason. Intravesical anticholinergic pharmacotherapy can be a treatment option in women with severe urge incontinence.

Administration, Intravesical↗
PubMedDate not supplied

Adjuvant intravesical treatment with a standardized mistletoe extract to prevent recurrence of superficial urinary bladder cancer.

BACKGROUND: Adjuvant intravesical Bacillus Calmette-Guerin (BCG) treatment after resection of non invasive superficial bladder cancer has been shown to significantly decrease tumor recurrence. However, the serious local and systemic side-effects of this treatment have promoted the use of other immunoactive substances, which, to date, have all failed to show efficacy equal to BCG therapy. PATIENTS AND METHODS: In the present phase I/II clinical trial, an aqueous mistletoe extract, standardized to mistletoe lectin, was applied intravesically to 30 patients with superficial urothelial bladder carcinomas of stages pTa and pT1, grades 1 to 2. After transurethral resection, each patient received 6 instillations at weekly intervals of 50 ml of the extract with mistletoe lectin concentrations between 10 ng/ml and 5000 ng/ml. This was retained in the bladder for 2 hours. Three patients per group received a dose, which was then doubled in the next group. The clinical follow-up consisted of examinations by cystoscopy, cytology and random biopsies. RESULTS: Within the observation time of 12 months, 9 patients had tumor recurrence, while 21 patients remained tumor-free. This recurrence rate was comparable to that of local historical controls with superficial bladder cancer of the same stages and grades that had been treated with adjuvant BCG. The tolerability of the intravesically-administered mistletoe extract was very good. None of the study patients had local or systemic side-effects according to the WHO classification 1-4. CONCLUSION: From these results, it is concluded that the standardized mistletoe extract could be a potential adjuvant therapy for superficial bladder cancer. Further studies may show the optimal intravesical treatment regimen.

Administration, Intravesical↗
PubMed1989

Control of persistent vesical bleeding due to radiation cystitis by intravesical application of 15 (S) 15-methyl prostaglandin F2-alpha.

A 45 year old female who received radiotherapy for stage II-B uterine cervical cancer four and half years ago, presented with persistent hematuria due to radiation cystitis. 15 (S)-15-methyl prostaglandin F2-alpha (1 mg in 100 ml of normal saline) was instilled into the bladder daily for two days. The severity of bleeding decreased considerably. However, significant hematuria recurred 19 days later which continued despite bladder irrigation with normal saline. 1 mg of 15 (S) 15-Me PGF2 alpha mixed with hydroxyethyl cellulose gel to a volume of 10 ml was then instilled into the urinary bladder daily for three days and macroscopic hematuria ceased. Urinary frequency and urgency were the side effects which lasted for ten days. There has been no recurrence of macroscopic hematuria during the five months follow-up. In conclusion, 15 (S) 15-Me PGF2-alpha may be administered intravesically to control moderate hematuria due to radiation cystitis.

Administration, Intravesical↗
PubMed2003

Intravesical Bacillus Calmette-Guerin for treating bladder cancer.

Bladder cancer continues to be a leading cause of malignant neoplasm in men. Since 1976, Bacillus Calmette-Guerin (BCG) has been a recommended treatment for superficial bladder malignancy. BCG treatment indications, administration, side effects, patient education, and nursing implications are discussed.

Adjuvants, Immunologic↗
PubMed2004

Intravesical instillation of cidofovir in the treatment of hemorrhagic cystitis caused by adenovirus type 11 in a bone marrow transplant recipient.

Hemorrhagic cystitis that occurs late after bone marrow transplantation (BMT) in BMT recipients is often associated with adenovirus or polyomavirus BK infections. Intravesical instillation of cidofovir in a BMT recipient with intractable hemorrhagic cystitis resulted in clinical improvement. Local cidofovir therapy for viral hemorrhagic cystitis could be an alternative to intravenous administration of cidofovir.

Adenoviridae↗
PubMed1992

Intravesical epsilon aminocaproic acid in management of intractable bladder hemorrhage.

Thirty-seven patients with intractable bladder hemorrhage were treated with intravesical epsilon aminocaproic acid (EACA). Radiation cystitis and cyclophosphamide-induced cystitis were the two most common causes of intractable bladder hemorrhage. Thirty-four patients responded to treatment. No side effects were noted. Intravesical EACA appears to be a safe and effective method to control intractable bladder hemorrhage.

Administration, Intravesical↗
PubMed2000

Intravesical neuromodulatory drugs: capsaicin and resiniferatoxin to treat the overactive bladder.

Current pharmacologic treatment of the overactive bladder relies on anticholinergic drugs. However, these drugs often have troublesome side effects and frequently are given in doses insufficient to restore continence in patients with detrusor instability. We present the background and basic and clinical research dealing with intravesical instillation of capsaicin and resinfferatoxin as treatments for the overactive bladder. Capsaicin is the main pungent ingredient in "hot" peppers of the genus Capsicum. It is a specific neurotoxin that desensitizes C-fiber afferent neurons, which may be responsible for the signals that trigger detrusor overactivity. Studies with capsaicin over the past 8 years have demonstrated clinical efficacy with minimal long-term complications. Most of these studies have also shown that the acute pain and irritation associated with capsaicin are a major deterrent to widespread use. Resiniferatoxin (RTX), an ultrapotent analog of capsaicin that appears to have similar efficacy but with much less acute side effects may be more useful. Intravesical instillation of capsaicin or resiniferatoxin is a promising treatment for the overactive bladder.

Administration, Intravesical↗