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Bladder tumors are one of the most common tumors of the urinary system, accounting for the highest morbidity and mortality rates of urological tumors in China, and the recurrence rate of postoperative tumors is also high. In recent years, bladder instillation of gemcitabine after bladder cancer surgery has been started in clinical practice. In this review, the dose, infusion method, and treatment time of commonly used bladder infusions of gemcitabine were summarized, the advantages of gemcitabine for postoperative bladder infusion in bladder cancer were reviewed, and the care related to the process of bladder infusion and the management of related complications were discussed.
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AIM: To investigate the efficacy of bladder infusion of sodium hyaluronate (HA) in the treatment of interstitial cystitis (IC) at different temperatures. METHODS: Forty patients with IC admitted in our hospital from March 2018 to April 2019 were simply randomized and divided into two groups for prospective study, with 20 patients in each group. The temperature of perfusion fluid in normal temperature group was 37 ℃, and the temperature of perfusion fluid in high temperature group was 43 ℃. Compared the two groups before treatment, one month after treatment, and three months after treatment of interstitial cystitis problem score (ICPI), interstitial bladder symptoms score (ICSI), pre-veeing pain visual analogue score (VAS), and anxiety self-assessment scale (SAS), depression self-assessment scale (SDS), quality of life score (QOL), daily urination times, maximum bladder volume, bladder mast cell count, and immune factors [interleukin (IL)-6, IL-10] expression. RESULTS:The ICPI, ICSI, VAS, SAS, and SDS scores of the hyperthermia group were lower than those of the normal temperature group after one month and three months of treatment, and the QOL scores were higher than those of the normal temperature group after three months of treatment (P0.05). CONCLUSION:Compared with 37 ℃, intravesical instillation of HA in the treatment of IC can effectively relieve the clinical symptoms and signs of patients when the perfusion fluid is at a temperature of 43 ℃, and it improves the maximum bladder capacity and anxiety and depression, improves the quality of life of patients, which is safe and reliable. The mechanism may be related to the regulation of large cell, IL-6, IL-10 of bladder mucosa.
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OBJECTIVE@#To explore the clinical efficacy of electroacupuncture nerve stimulation therapy (ENST) for interstitial cystitis/painful bladder syndrome (IC/PBS).@*METHODS@#A total of 68 patients with IC/PBS were randomly divided into an observation group and a control group, 34 cases in each one. The patients in the observation group were treated with ENST; abdominal four acupoints and sacral four acupoints were connected with a pair of electrodes and treated alternately every other day. The ENST was given 50 min per times, three times a week for 3 months. The patients in the control group were treated with perfusion therapy of four-medication combination (heparin sodinm, lidocaine, sodium bicarbonate, gentamicin sulfate), twice a week for the first 6-8 weeks, followed by twice per month for 3 months. The infusion fluid remained for 1 h before discharging. The O' Leary-Sant score, including interstitial cystitis symptom index (ICSI) and interstitial cystitis problem index (ICPI), 24 h urination frequency, visual analogue scale (VAS) and maximum bladder volume were observed before treatment and treatment of 1 month, 3 months and 6 months after treatment respectively; the adverse events during the treatment were also recorded.@*RESULTS@#Compared before treatment, the O'Leary-Sant score (ICSI, ICPI), 24 h urination frequency, VAS and maximum bladder volume in the two groups were improved after 1, 3 months treatment and 6 months after treatment (all <0.05). The scores of ICSI, ICPI, VAS and 24 h urination frequency in the observation group were significantly lower than those in the control group (<0.05). The maximum bladder volume in the observation group was significantly higher than that in the control group (<0.05). Six months after treatment, the total effective rate in the observation group was 87.5% (28/32), which was higher than 69.7% (23/33) in the control group (<0.01). No significant adverse events occurred during the treatment.@*CONCLUSION@#ENST could effectively relieve the clinical symptoms of IC/PBS, but its long-term efficacy needs further observation.
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Humans , Cystitis, Interstitial , Therapeutics , Electroacupuncture , Pain , Pain Management , Treatment Outcome , Urinary Bladder Diseases , TherapeuticsABSTRACT
Objective To investigate the clinical effects of transurethral resection of cystitis after gynecological cystitis after transurethral resection of bladder,and to observe the effect on patients' anxiety(SAS)and quality of life index(QOL).Methods The clinical data of 62 patients with cystitis glandularis admitted to hospital from January 2011 to December 2016 were retrospectively analyzed.The control group was treated with plasma ablation alone,with plasmakinetic resection of Kangfuxin liquid combined with gemcitabine intravesical therapy as the treatment group,31 cases in each group.Statistics of two groups of patients with clinical efficacy,followed up for 12 months,and the anxiety self-rating scale(SAS)was used to evaluate the anxiety of the two groups before and after treatment,QOL was used to evaluate the quality of life before and after treatment in two groups of patients.The recurrence rate of two groups were recorded.Results After treatment,the effective rate of the treatment group was 80.65％,slightly higher than the control group 77.42％,the difference was statistically significant(P<0.05),the SAS score in the treatment group was slightly higher than before treatment,but the difference was not statistically significant,the SAS score in the control group was significantly lower than before treatment,after treatment between the groups,the difference was statistically significant(P<0.05).The QOL index of the treatment group decreased slightly after treatment,but the difference was not statistically significant.The QOL index of the treatment group decreased significantly after treatment,and compared between the two groups after treatment,the difference was statistically significant(P<0.05).Follow-up of 12 months,the relapse rate in the treatment group was 11.11％,slightly lower than the control group 18.75％,the difference was statistically significant(P<0.05).Conclusion Compared to pure plasmapheresis,the use of postoperative intravesical instillation of bladder irrigation with the same effect,but the latter may increase the degree of anxiety in patients,thus affecting the quality of life of patients,so for the non-mandatory use of drugs treatment,surgery may be given priority to surgery alone.
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Objective To evaluate the efficacy of bladder perfusion with sodium hyaluronate combined with ultrashort wave irradiation in bladder region in treatment of glandular cystitis.Methods 22 patients diagnosed as typical glandular cystitis were selected from our hospital between March 2013 and March 2013. Those patients were given bladder perfusion with sodium hyaluronate combined with ultrashort wave irradiation in bladder region according to the designed course. The lesion areas were taked photos and bited samples for microscopic observation and HE staining.The evaluation indicators include pelvic pain and urgency/frequency symptom scores,cystitis histologic scores ,infiltrating lymphocyte counts, Brunn nest or cystica counts and residual urine volume were measured in the self-control expertiment before treatment and after. Results Over the course of treatment, above mentioned indicators had significant improvement compared with original data among those patients (P<0.01).Only 1 patient appeared itchy skin two times after bladder perfusion with sodium hyaluronate, others without serious complications. Conclusions The method that bladder perfusion with sodium hyaluronate combined with ultrashort wave irradiation has clear effect without serious complications.This method provides a new train of thought for glandular cystitis and opens up a new space.
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Non-muscle invasive bladder cancer (NMIBC) represents the malignant tumor of urinary bladder which is limited to mucosa and submucosal.NMIBC has high recurrence,and can progress to muscle invasive bladder cancer.Adjuvant intracavitary perfusion is beneficial for patients after surgery.There are many drugs for intravesical instillation in clinic.However,the new bladder perfusion drug which is safer and more effective,is always a research hotspot.
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Objective To evaluate the clinical significance of bladder saline perfusion before catheter removal in TURP patients. Methods From 2009 to 2011,140 patients received TURP were enrolled in this study.Patients were divided into perfusion group (70 cases with bladder saline perfusion before catheter removal) and control group (70 cases without perfusion). Results Comparing with the control group (33.1 ± 5.4) min,the time waiting for urination was shorter in perfusion group ( 3.7 ± 0.2 ) min ( P ＜0.05 ).The recovering time to normal urination was shorter in perfusion group (7.7 ± 1.2 ) d than in control group (11.7 ± 1.3) d (P ＜ 0.05 ) as well.In the first urine after catheter removal and first urine on the next day morning,white blood cell count of 2 groups (4.5 ± 0.1 ) vs ( 6.9 ± 3.5 ) ; ( 3.7 ± 0.2 ) vs (4.3 ±0.5) had significant differences ( P ＜ 0.05 ). Conclusion Bladder saline perfusion before catheter removal in TURP patients is simple and effective for the restoration of normal voiding.
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Objective To compare the result of T2/T3 transitional cell carcinoma (TCC) of the urinary bladder after segmental cystectomy, treated by postoperative radiation plus intravesical chemotherapy and postoperative intravesical chemotherapy alone.Methods From 1985 to Dec.1995 patients with T2/T3 TCC bladder cancer who had been treated by segmental cystectomy were eligible for this retrospective analysis. Fifty-eight patients received postoperative radiotherapy plus intravesical chemotherapy (RT+IVC) and 35 patients were given postoperative intravesical chemotherapy (IVC) with thio-TEPA or calmette-Gue'rin bacilli (BCG). For radiation,8 or 18 ?MV X-ray was given with total dose of 50-60 ?Gy. Vesicoclysis was performed on 50-60 mg thio-TEPA twice per week and 0.5 mg BCG per week.Results The 3-year local control rates of RT+IVC and IVC groups were 68.6% and 48.2% showing a difference statistically significant (? 2=4.08,P=0.044).The 3- and 5-year survival rates of RT+IVC and IVC groups were 70.7%,49.5% and 59.9%,35.7% ,showing no significant difference (? 2=1.77,P=0.184). Among the 5 year survivors of the RT+IVC patients, 78.6% had their bladder preserved. Though untoward radiation reactions were severer, they were tolerated well.Conclusions Combined radiation therapy plus intravesical chemotherapy is indicated for T2/T3 bladder cancer after segmental cystectomy. Multimodality therapy is more favored to improve both the local control and the possibility of preserving the bladder.