No abstract available.
Administration, Intravesical* ; Humans ; Reflex, Abnormal*

In clinical settings, intravesical instillation of a drug bolus is often performed for the treatment of bladder diseases. However, it requires repeated instillations to extend drug efficacy, which may result in poor patient compliance. To alleviate this challenge, implantable devices have been developed for the purpose of sustained, intravesical drug delivery. In this review, we briefly summarize the current trend in the development of intravesical drug-delivery devices. We also introduce the most recently developed devices with strong potential for intravesical drug-delivery applications.
Administration, Intravesical ; Drug Delivery Systems ; Patient Compliance ; Urinary Bladder Diseases

No abstract available.
Administration, Intravesical* ; Photochemotherapy* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

No abstract available.
Administration, Intravesical* ; Photochemotherapy* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Local instillation of Thio-tepa (triethylene thiophosphoramide) is widely used as an important adjunct in the management of papilloma of the bladder. We herein report the 10 case of the bladder cancer administered with Thio-tepa for the treatment and prophylaxis.
Administration, Intravesical* ; Papilloma ; Thiotepa* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

A study was performed to determine the prophylactic efficacy of intravesical BCG instillation in 35 patients with recurrent (more than 3), multiple (more than 3) or large (more than 3cm.) superficial bladder tumors(stage Ta or T1). Of the patients 20 were treated with 6 weekly intravesical instillations of 120mg. Pasteur strain BCG after transurethral resection and 15 were followed conventionally. The recurrence rate was 16.2 per cent in the BCG group and 40.1 per cent in the controls during the first 3 months, and it was 39.6 and 92.6 per cent, respectively during l2 months (p<0.005, logrank),Recurrence per 100 patient-months were 5.13 and 11.68, respectively (p<0.00l,chi-square). One patient in the BCG group and 3 controls had recurrent tumors with progression in stage. We conclude from these observations that intravesical BCG instillation is effective in the prophylaxis of tumor recurrence in patients at high risk.
Administration, Intravesical ; Bacillus* ; Humans ; Mycobacterium bovis ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: Animal tumor models are important for the evaluation of novel therapeutic modalities. Since the initial report of an orthotopic bladder tumor model, several modifications have been proposed to improve the tumor take rate. Here we compared the HCl-pretreated and electrocauterization-pretreated orthotopic murine bladder tumor models. MATERIALS AND METHODS: MBT-2 murine bladder cancer cells were transurethrally implanted in the bladder of syngeneic C3H/He mice. The mice were divided into three groups according to pretreatment methods (electrocautery, HCl, and control group) and were subjected to pretreatment before instillation of MBT-2 tumor cells into the bladder. Mice were sacrificed on day 21, and bladders were harvested, weighed, and examined histopathologically. RESULTS: The tumor take rate of the control, electrocautery, and HCl groups was 0%, 54%, and 100%, respectively. The tumor take rate of the HCl group was significantly higher than that of the control group (p<0.01) and the electrocautery group (p=0.01). Pathologic reports revealed that all established bladder tumors were high-grade papillary urothelial carcinomas. CONCLUSIONS: The HCl pretreatment model was a preferable murine bladder tumor model for evaluating further therapeutic interventions.
Administration, Intravesical ; Animals ; Electrocoagulation ; Mice ; Models, Animal ; Urinary Bladder ; Urinary Bladder Neoplasms

PURPOSE: To determine the efficacy of intravesical hyaluronic acid (HA) instillation in treating patients with refractory interstitial cystitis/painful bladder syndrome (IC/PBS) and to identify any related factors that influence its therapeutic effect. METHODS: Thirty-three female IC/PBS patients who demonstrated poor or unsatisfactory responses to previous treatments between December 2010 and October 2012 were enrolled. Despite previous treatments, the enrolled patients had visual analogue scale (VAS) pain scores > or =4 and total scores (symptom and bother scores) > or =13 on the pelvic pain and urgency/frequency (PUF) questionnaire and > or =12 on the O'Leary-Sant interstitial cystitis symptoms index (ICSI)/problems index (ICPI). All patients received once weekly intravesical instillations of 40-mg HA diluted in 50-mL saline for 4 weeks. The efficacy of the HA instillation was evaluated by comparing the mean changes in the scores of the VAS and questionnaires from baseline to 4 weeks after treatment. Improvement was defined as a > or =2 decrease in the VAS. Moreover, we investigated the effects of the presence of Hunner's ulcer and previous treatment modalities on the therapeutic outcome of HA instillation. RESULTS: The mean age was 57.0+/-1.8 years (range, 28-75 years). The VAS score significantly decreased from baseline to 4 weeks after treatment (-2.5, P<0.001). The mean changes in the PUF, ICSI, and ICPI from baseline to 4 weeks after the treatment were -3.8 (P<0.001), -2.3 (P<0.001), and -2.7 (P<0.001), respectively. Twenty patients (61%) showed improvements. Previous treatment modalities did not affect the efficacy of HA instillation and the presence of Hunner's ulcer was unrelated to outcomes. No complications were observed. CONCLUSIONS: These results show that intravesical HA instillation is an effective and safe treatment for patients with refractory IC/PBS. Previous treatment modalities and presence of Hunner's ulcer do not affect the efficacy of HA instillation.
Administration, Intravesical ; Cystitis, Interstitial ; Female ; Humans ; Hyaluronic Acid* ; Pelvic Pain ; Sperm Injections, Intracytoplasmic ; Ulcer ; Urinary Bladder*

Cells or the monocyte-macrophage lineage are known to exhibit tumoricidal activity following stimulation by BCG, interferon -gamma (INF-gamma) or bacterial products such as lipopolysaccharide(LPS). While the mechanisms involved remain obscure, the generation of reactive nitrogen intermediateds (RNI) by activated macrophage is considered a major participant in mediating the tumoricidal effect. In this study, the authors intended to know the effects of BCG infection on the production and secretion of RNI in the experimental animals. Sprauge-Dawley rats were instillated with BCG intravesically. The production of RNI from peritoneal macrophages and urinary secretion of RNI were measured after intravesical BCG instillation of the rats. The urinary concentration(micrometer/L) of nitrite, stable oxidized form of nitric oxide(N0-), 1 week after intravesical BCG instillation was 20+/-0.5 in the group I (control). 54+/-1.0 in group II (BCG 1x). 63+/-0.5 in group III (BCG 10x) and 17+/-0.5 in group IV (BCG 10x + N(G)MMA). The urinary nitrite concentration(micrometer/L) 3 weeks after intravesical BCG instillation was 17+/-2.0 in group I, 124+/-3.0 in group II, 210+2.5 in group III and 31+/-0.5 in group IV. The production of RNI by peritoneal macrophages 3 weeks after intravesical BCG instillation increased in group III (45+/-2.0 micrometer/L) compared to group I (5+/-1.0 micrometer/L). The peritoneal macrophages treated with LPS and INF-gamma increased nitrite production (36+/-0.5 in group I , 52+/-1.5 micrometer/L in group III). The production of RNI by peritoneal macrophages was inhibited by the treatment of the rats with N(G)MMA (19+/-0.5 in group 1, 17+/-1.5 micrometer/L in group III). The results of this study showed that BCG infection of the rat via intravesical instillation makes the peritoneal macrophages produced RNI and increases the secretion of RNI in the urine. This study suggest that the effects of BCG infection for the treatment of bladder cancer might be mediated by the production or RNI in the tumor bearing host.
Administration, Intravesical ; Animals ; Interferons ; Macrophages ; Macrophages, Peritoneal* ; Mycobacterium bovis* ; Negotiating ; Nitrogen* ; Rats* ; Urinary Bladder Neoplasms

PURPOSE: We compared the prophylatic effects and complications of intravesical instillation of the epirubicin and Bacillus Calmette-Guerin (BCG) in patients with stage T1 bladder cancer. MATERIALS AND METHODS: A total 87 patients with stage T1 bladder cancer were treated with transurethral resection (TUR) between January 1992 and April 1998. Of them, 51 patients received BCG (Connaught strain, 81mg), 16 patients received 50mg epirubicin and 20 patients underwent TUR alone. The patients were followed for 18-78 months (mean 40 months). Recurrence rates, progression rates, mean months to tumor recurrence, recurrence free survival rate using Kaplan-Meier curve and complications were compared among three groups. RESULTS: The overall recurrence rate was 27.5% in BCG group, 37.5% in epirubicin group and 65% in control group. Mean months to tumor recurrence and recurrence free survival rate showed that both drugs were superior to TUR alone. The incidence of complications was 94% in BCG group and 12.5% in epirubicin group. CONCLUSIONS: BCG and epirubicin were superior to TUR alone in the prophylaxis of recurrence in stage T1 bladder cancer. Although the prophylactic efficacy of BCG was a little higher than that of the epirubicin, the toxicity rate of epirubicin was much lower than that of BCG. Therefore, epirubicin may be regarded as an alternative treatment of the BCG, especially for the patients who cannot tolerate the side effects of BCG.
Administration, Intravesical ; Bacillus* ; Epirubicin* ; Humans ; Incidence ; Mycobacterium bovis ; Recurrence ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*