Treatment of muscle invasive bladder tumor comparison between chemotherapy and cystectomy

Bladder Tumor is the second most common cancer of the genitor-urinary tract. Male to Female ratio: has been demonstrated as 3.5:1. To compare the efficacy of combined chemotherapy/or radical cystectomy with or without urinary diversion. The present study was conducted on 26 consecutive patients of either age and sex having histologically proven muscle invasive transitional cell carcinoma of the bladder .These patients were selected from different hospitals in Lahore including Lahore General Hospital, Mayo Hospital, Shaikh Zaid Hospital, and Services Hospital from 1994-1996. These patients were thoroughly investigated. At the initial diagnosis 18-30% of patients of bladder tumors are muscle invasive and 70% superficial. Although radical cystectomy is the treatment of choice for invasive bladder tumor, bladder-sparing technique are more often being used e.g. TURGB and Intra-vesicle chemo/immunotherapy in superficial bladder cancer, TURGB and Systemic chemotherapy in muscle invasive tumor. The use of combination Chemotherapy in advance disease is routine e.g. CMV and MVAC. In our present study a total of 26 consecutive patients of either age or sex having histologically proven muscle invasive tumor of bladder were included. These patients were collected from different hospitals at Lahore, from 1994 to 1996. Out of these 26 patients, 13 patients were included in group-A, [they were given MVAC chemotherapy] and the remaining 13 patients were included in group B, [in these patients cystectomy and urinary diversion were done]. It is concluded that the result using combined Chemotherapy MVAC are better [20%] as compared to total cystectomy/urinary diversion [12.23%] after one year follow up

Comparison of transvesical repair of vesico-vaginal fistula and use of free bladder mucosal graft

This study was designed to compare the efficacy and complications of the conventional transvesical repair of vesicovaginal fistula versus new technique using free bladder mucosal graft for repair. It was carried out on 16 patients aged 16-45 years in the Departments of Urology, Services Hospital and Jinnah Hospital, Lahore from 1999 to 2001. Patients were randomly divided into two groups A and B. In group A, 8 patients who underwent conventional transvesical repair of.vesicovaginal fistula whereas in group B, 8 patients who underwent repair using free bladder mucosal graft. Out of 16 patients, the recurrence was observed in 3 patients [37.5%] in group A and i patient in group B, [12.5%]. There was statistically no significant difference P > 0.05. The transvesical free bladder mucosal graft repair provides good result with minimum complications. This method is recommended for routine repair of vesicovaginal fistulae without extensive dissection of the diseased area