Article
Mitomicina C: una nueva alternativa para la estenosis de cuello vesical
Fecha
2016-12Autor
Olmedo, Tomas
Hidalgo, Juan
Reyes, Diego
Marchant, Fernando
Ledezma, Rodrigo
Aliaga, Alfredo
Fleck, Daniela
Castro, Iñaki
Barahona, Jaime
Abad Vázquez, Jaime Patricio
Institución
Resumen
Introduction: The mitomycin C is a chemotherapeutic
agent by virtue of its antiproliferative and antibiotic activity.
We evaluated the outcome of endoscopic radial
cervicotomy combined with intralesional mitomycin C
injection for the treatment of severe bladder neck stenosis
after traditional treatment failure.
Materials and methods: It was a retrospective review
of patients with severe bladder neck stenosis who had
a surgery between July 2013 and August 2015 with mitomycin
C. The 54.5% of patients had failed at least 1
time with internal cervicotomy and/or endoscopic resection
of the bladder neck. In our intervention, three or
four endoscopic incisions were performed with a cold
cut in the neck of the bladder, followed by intralesional
injection of 0.3 to 0.4 mg / ml of the mitomycin C at
each incision site.
Results: A total of 11 patients were treated with endoscopic
incision with a cold cut in the neck of the bladder
combined with mitomycin C injection. Before the surgery
4 patients (36%) were cystostomy users. At a mean
follow-up of 9 months (range 1-20), 9 patients (82%) had
spontaneous urine after 1 procedure, while 2 patients
(18%) achieved this goal after 2 procedures using mitomycin
C.
Conclusions: The treatment for bladder neck stenosis
with endoscopic radial cervicotomy with cold cut combined
with intralesional mitomycin C injection resulted
in bladder neck permeability in 82% of patients after 1
procedure and 100% after 2 procedures. Although the
first results are promising, some prospective and randomized
studies with long-term monitoring are required to
validate these findings