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

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*

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

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*

PURPOSE: This study aimed to verify the efficacy and safety of intravesical treatment with sodium chondroitin sulfate (CS) in patients with overactive bladder (OAB) who are refractory to previous antimuscarinic treatment. METHODS: This study was performed between June 2012 and January 2015 and included 31 consecutive women (mean age, 42.10+/-7.34 years) with OAB who had been previously treated with two types of antimuscarinic drugs. The results of gynecologic and cystoscopic examinations were normal, and OAB comorbidity was absent. Treatment with intravesical instillations containing 40 mL CS (0.2%; 2 mg/mL) was administered for 6 weeks; after weekly treatments, monthly treatments were administered. The OAB-validated 8 (OAB-V8) symptom scores, nocturia, frequency, urgency, urge incontinence, and urinary volumes measured by uroflowmetry were evaluated for all the patients. The values obtained before the treatment were statistically compared with those obtained six months after the treatment. RESULTS: The duration of the symptoms was 18.36+/-6.19 months. A statistically significant improvement of the patients' conditions was observed in terms of the OAB-V8 symptom scores, nocturia, frequency, urgency, urge incontinence, and urinary volumes measured by uroflowmetry after the treatment. CONCLUSIONS: Despite the limitations of this study, the outcomes confirmed that CS therapy is safe and effective for the treatment of OAB.
Administration, Intravesical ; Chondroitin Sulfates ; Chondroitin* ; Comorbidity ; Female ; Humans ; Nocturia ; Sodium* ; Urinary Bladder, Overactive* ; Urinary Incontinence, Urge

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 analyzed the impact of immediate intravesical mitomycin C instillation after transurethral resection of the bladder (TURB) on tumor recurrence and progression in patients with periodic mitomycin C instillation. MATERIALS AND METHODS: Between June 2000 and June 2006, a retrospective study was performed in a total of 115 patients with primary bladder tumors receiving a 6-week course of mitomycin C instillation after TURB. The patients were assigned to two groups: 53 patients in the immediate mitomycin C (I-MMC) group were treated by immediate instillation of mitomycin C after TURB and periodic instillation (6 times, 1 time per week), and 62 patients in the MMC group received only periodic instillation. Tumor recurrence and progression were compared in the two groups. RESULTS: During the mean follow-up period of 46.5 months in the I-MMC group and 47.2 months in the MMC group, early recurrence (within 1 year) occurred in 6 of 53 patients (11.3%) in the I-MMC group and in 18 of 62 patients (29.0%) in the MMC group (p<0.02). Although a significantly lower early recurrence rate was observed in the I-MMC group, this difference was not significant for recurrence within 2 or 3 years or for total recurrence. Progression was not significantly different between the two groups regarding the early and total period. CONCLUSIONS: Our study confirmed the positive effect of a single, immediate mitomycin C instillation in patients with non-muscle-invasive bladder tumors who received periodic mitomycin C instillation. This benefit was limited to early recurrence and was not maintained with long-term follow-up. This approach can be an alternative to periodic mitomycin C instillation without immediate instillation.
Administration, Intravesical ; Follow-Up Studies ; Humans ; Mitomycin ; Recurrence ; Retrospective Studies ; Urinary Bladder ; Urinary Bladder Neoplasms

PURPOSE: To investigate the safety and the efficacy of intravesical gemcitabine therapy, we prospectively studied intravesical gemcitabine instillation followed by Bacillus Calmette-Guerin(BCG) instillation for treating the patients who suffer from superficial bladder cancer, and the above method was then compared with conventional BCG instillation. MATERIALS AND METHODS: Between May 2005 and April 2007, a total of 84 patients were divided into Group I: the patients were treated with a 2-week course of gemcitabine(1,000mg/50ml, 2,000mg/50ml) followed by a conventional 6-week course of BCG, and Group II: the patients were treated by BCG instillation only. Gemcitabine was instilled immediately within 6 hours after complete trans-urethral resection of the bladder tumor (TURBT) and then this was repeated one week later. BCG instillation was started 2 weeks after TURBT. The complications, recurrence rates, progression rates and recurrence-free period(RFP) were analyzed in both groups. RESULTS: The treatment was well tolerated in all the patients. Most of the complications were self-limiting, and there was no significant difference between the two groups(p=0.379). The recurrence rates of the two groups were 25.6% and 26.7%, respectively(p=0.899). Yet the recurrence-free period(RFP) was significantly longer in Group I(p=0.021). The progression rates of the two groups were 2.6% and 6.7%, respectively(p=0.620). CONCLUSIONS: Intravesical gemcitabine instillation showed the effect to prolong the recurrence-free period for patients with superficial bladder cancer. Further long-term study will be needed.
Administration, Intravesical ; Bacillus ; Deoxycytidine ; Humans ; Mycobacterium bovis ; Prospective Studies ; Recurrence ; Urinary Bladder ; Urinary Bladder Neoplasms