Mitomicina C: una nueva alternativa para la estenosis de cuello vesical

Abstract

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