[ comparison between intravesical chemotherapy and immunotherapy on superficial carcinoma of the bladder]

Intravesical chemotherapy or immunotherapy is the main point in treatment of superficial transitional cell carcinoma of bladder after performing TURBT[1]. But these methods have some limitations in terms of therapeutic response and the rate of complications. This study was performed to evaluate the complication rate, response to treatment and relapse of TCC[2]after mixed chemotherapy with Thiotepa and Mitomycine C in comparison with immunotherapy by BCG. In this clinical trial a total of 140 patients who admitted in urology department of Ghaem and Musa-Ebne-Jafar Hospital due to superficial TCC, were divided into 4 groups of 35. After TURBT, patients in first group were treated by Thiotepa, on second and third group we used monotherapy with Mitomycine C, BCG, respectively. So in the last group mixed therapy with Thiotepa plus Mitomycine C was performed. All patients in each group were followed by physical exam, lab tests [CBC, U/A] and cystoscopy every 3 months for the first 2 years, and then every 6 months until the end of study. CBC tests were performed before and after 8 weeks of every of therapy. Then gathering data was analyzed through statistical methods. In this study, maximum prevalence rate of TCC was in 7 and 8 decades with an average of 66 years old. In patients there was 3.5% T[Is], 43.5% stage T[a] and 53% stage T[1]. Tumors were mostly seen in the lateral walls and the base of bladder [94%]. In the group which treated with intravesical BCG, the recurrence rate of carcinoma was apparently lower than other groups and the remission's time was longer. The highest incidence rate of acute cystitis was seen in BCG-Therapy group, while in the mixed therapy group was lowest. Hematologic and allergic side-effects were significantly lower with mixed therapy in comparison with monotherapy methods. Rate of recurrence in BCG-therapy is lower but its complications, especially acute cystitis, is common. Administration of mixed therapy has been successful in reducing complications [both systemic and local]; but the therapeutic response was like the monotherapy treatment

comarative evaluation of sonourethrography versus urethrography with intraoperative findings in urethral phatologies prospective study

Purpose: To evaluate stricture and disruption of the male urethra with the help of sonography and to evaluate the efficacy of Sonourethrography [S.U.G.] and up and down Sonourethrography as compared to conventional radiographic procedures as retrograde urethrography [RUG] and up and down urethrography

Material and Methods: In the period of 25 months, we evaluated 35 patients [31 patients with urethral strictures and 4 patients with urethral disruption] with urethrography and S.U.G. Age of the patients varied between 12-85 years [mean 39 y]. We analyzed stricture length, depth of spongiofibrosis, urethral defect, and satisfaction and compared the results. We also analyzed the results of imaging with urethroscopic and surgical results

Results: The depths of spongiofibrosis concluded grade A in one [3.2%], grade Bin 12 [37.8%], grade C in 11 [35.4%], grade D in 2 [6.4%] and grade E in 2 [6.4%]. Spongiofibrosis wasn't valuable in 3 [9.6%] patients. The length of the stricture was better demonstrated by sonography [p= 0.000]. We didn't find important differences concerning results of up and down Sonourethrography and up and down urethrography in patients with urethral disruption [p= 0.18]. Patients were more satisfied from sonographic study than urethrography [p=0.000]

Conclusion: S.U.G. is a simple and available procedure without radiation exposure S.U.G. is more sensitive in defining the length and the depth of strictures. Grade B was the most common from of spongiofibrosis in our study. Patients were more satisfied from sonographic study than urethrography. Up and down Sonourethrography could be helpful in defining the length of defect in urethral disruption