MP13-06 CAN INTRAVESICAL ADMINISTRATION OF ANTIFIBRINOLYTIC AGENT POTENTIATE THE ACTION OF BACILLUS CALMETTE- GUERIN AFTER TRANSURETHRAL RESECTION OF NON–MUSCLE INVASIVE BLADDER CANCER?: MULTICENTER PROSPECTIVE RANDOMIZED CONTROLLED STUDY.

Abstract

You have accessJournal of UrologyBladder Cancer: Non-Invasive I1 Apr 2016MP13-06 CAN INTRAVESICAL ADMINISTRATION OF ANTIFIBRINOLYTIC AGENT POTENTIATE THE ACTION OF BACILLUS CALMETTE- GUERIN AFTER TRANSURETHRAL RESECTION OF NON–MUSCLE INVASIVE BLADDER CANCER?: MULTICENTER PROSPECTIVE RANDOMIZED CONTROLLED STUDY. Mohamed Soliman, Hussein Aldaqadossi, Ahmed El-Abd, Ahmed Abou- Ramadan, Mohamed El-Gharabawy, Abd-Elhamid El-Bahnasy, and Mohamed Abd-Eltawab Mohamed SolimanMohamed Soliman More articles by this author , Hussein AldaqadossiHussein Aldaqadossi More articles by this author , Ahmed El-AbdAhmed El-Abd More articles by this author , Ahmed Abou- RamadanAhmed Abou- Ramadan More articles by this author , Mohamed El-GharabawyMohamed El-Gharabawy More articles by this author , Abd-Elhamid El-BahnasyAbd-Elhamid El-Bahnasy More articles by this author , and Mohamed Abd-EltawabMohamed Abd-Eltawab More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2487AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Intravesical instillation of bacillus Calmette-Guerin (BCG) as an adjuvant therapy after transurethral resection of non–muscle invasive bladder cancer (TURBT) is considered to be the most effective treatment to prevent the recurrence and progression of the disease. The objective from this study is to evaluate the effect of intravesical instillation of antifibrinolytic agents with BCG in the management of superficial bladder tumors after TURBT. METHODS This study was conducted on cohort of patients with primary non–muscle invasive bladder cancer in whom the management decision included TURBT with intravesical BCG instillation postoperatively. Patients were managed by TURBT, two weeks later; patients were randomized into two groups. Patients in group A subjected to intravesical instillation of BCG plus 2 gm of tranexamic acid while patients in group B were subjected to intravesical instillation of BCG alone. Prothrombin time was determined at 2 hours after instillation. Complications in each group were reported. Follow-up cystoscopy was conducted three months after TURBT and then every three months during the first year followed by by annual cystoscopy in the following years. RESULTS This study included 96 patients with mean age of 52.4 ± 6.2. They were prospectively randomized into 2 groups (48 each). Follow-up ranged from 6 to 24 months (mean of 15.2 ± 9 months). Four patients were lost to follow up (2 in each group). Another 15 patients (8 in group A and 7 in group B) developed serious BCG complications and excluded from the study. Postoperative prothrombin time showed no significant difference between both groups (P= 0.3). In the remaining 77 patients (38 patients in group A and 39 patients in group B), recurrence was reported in 3 out of 38 patients in group A (7.9%) and 11 out of 39 patients in group B (28%) with a statistically significant difference between both groups (P=0.036). Progression was reported in only one patient in group A (2.6%) and 8 patients in group B (20.5%) with a statistically significant difference (P=0.0286). CONCLUSIONS Intravesical instillation of antifibrinolytic agents with BCG has improved the antitumor efficacy of BCG in the management of non–muscle invasive bladder cancer following TURBT. Further studies including large number of cases are required to support these findings. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e136 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Mohamed Soliman More articles by this author Hussein Aldaqadossi More articles by this author Ahmed El-Abd More articles by this author Ahmed Abou- Ramadan More articles by this author Mohamed El-Gharabawy More articles by this author Abd-Elhamid El-Bahnasy More articles by this author Mohamed Abd-Eltawab More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...