Endoscopic transurethral resection of bilharzial ulcers in the urinary bladder. Single-center experience with 1000 patients

ABSTRACT

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 (87.3males and 12.7females) with chronic bilharzial ulcers (78de novo and 22recurrent 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