RESUMO
Objective: To report on the results of endoscopic transurethral resection of chonic bilharzial ulcers of the urinary bladder at the Assiut University Hospital, Assiut, Egypt
Patients and Methods: Between June 1995 and April 2001, 1000 patients [87.3% males and 12.7% females] with chronic bilharzial ulcers [78% de novo and 22% recurrent ulcers after previous open partial cystectomy] were treated by endoscopic transurethral electroresection [TUR] at our department. Single ulcers were diagnosed in 612 [61.2%], double ulcers in 261 [26.1%] and multiple ulcers in 127 [12.7%] patients. Ulcers of a moderate diameter [1-2 cm] were present in 505 [50.5%] patients. Electroresection was done until healthy fibers of the detrusor muscle or even the prevesical fat was reached
Results: The mean duration of the resection was 19.8 minutes. Extraperitoneal bladder perforation was recorded in 11 patients [1.1%]. In all these patients conservation was successful. Intraperitoneal bladder perforation was recorded in 16 patients [1.6%]. In six out of these patients conservation was successful, while peritoneal drainage was necessary in the remaining cases. Conservative management was successful in 5 cases [0.5%] of secondary haemorrhage. Hospitalization was one day in 920 patients [92%]. After six months 862 patients [86.2%] were available for follow up. 745 [86.4%] were symptom-free and 794 [92.1%] reported complete healing of the resected ulcer at follow-up cystoscopy
Conclusion: Endoscopic transurethral electroresection is a satisfactory modality for the treatment of bilharzial ulcers of the urinary bladder