Increasing patient comfort by optimized postoperative administration of intravesical mitomycin C.

OBJECTIVE: To report a prospective controlled study to compare the acceptance of two different ways of administering intravesical mitomycin C, as the immediate intravesical administration of chemotherapy after surgery decreases the risk of recurrence in patients with superficial bladder cancer, but response rates are variable, partly because of inadequate drug delivery and thus an adequate administration time is important for optimum oncological efficacy. PATIENTS AND METHODS: Between October 2004 and June 2005, 60 patients were divided after transurethral resection of superficial bladder cancer into two groups. Both groups received an intravesical instillation of 40 mg mitomycin C diluted in 40 mL distilled water at

Dynamic transurethral sonography and 3-dimensional reconstruction of the rhabdosphincter and urethra: initial experience in continent and incontinent women.

OBJECTIVE: The purpose of this study was to evaluate the female urethra and the striated urinary sphincter, the rhabdosphincter (RS), by means of dynamic transurethral sonography and sonographic 3-dimensional (3D) reconstructions. METHODS: In 15 female patients with urinary stress incontinence (mean age, 67.5 years) and 5 continent women (mean age, 48.3 years), morphologic characteristics and function of the RS and urethra were examined with a 10-MHz transurethral ultrasound transducer. With the help of a mechanical pullback system, the transducer was slowly retracted to scan the whole urethra and the RS from the bladder neck to the urethral orifice. Subsequently, 3D reconstructions of the urethra using an integrated computer system were performed. The RS as well as the length of the urethra were investigated under contracted and noncontracted conditions to measure contractility of the RS and dynamic changes of the lower urinary tract. RESULTS: Partial or complete loss of RS function was detected in patients with stress incontinence. The findings on sonography were found to correlate well with the grade of incontinence. Furthermore, under contraction of the RS, a median increase in urethral length was observed. In incontinent patients, the increase in the urethral length was statistically significantly less (P = .04), which was related to the reduced contractility of the RS. CONCLUSIONS: Dynamic transurethral sonography with subsequent 3D reconstructions allows for assessment of function and morphologic characteristics of the RS and urethra. Normal contraction of the RS results in an elongation of the urethra.