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8. Local microwave hyperthermia and intravesical chemotherapy as bladder sparing treatment for select multifocal and unresectable superficial bladder tumors

Author

Colombo, R, Da Pozzo, L, Lev, A, Salonia, A, Rigatti, P, Leib, Z, Servadio, C, Caldarera, E, Pavone-Macaluso, M, Colombo R, Da Pozzo L, Lev A, Salonia A, Rigatti P, Leib Z, Servadio C, Caldarera E, Pavone-Macaluso M, Colombo, R, Da Pozzo, L, Lev, A, Salonia, A, Rigatti, P, Leib, Z, Servadio, C, Caldarera, E, Pavone-Macaluso, M, Colombo R, Da Pozzo L, Lev A, Salonia A, Rigatti P, Leib Z, Servadio C, Caldarera E, and Pavone-Macaluso M

Abstract

Purpose: The role of a combined regimen of local hyperthermia and topical chemotherapy in patients with multifocal and recurrent superficial bladder tumors not curable by transurethral resection was evaluated in a neodjuvant organ sparing clinical study. Materials and Methods: A total of 19 patients with multifocal, superficial grades 1 to 3 bladder tumors that recurred afar intravesical chemoprophylaxis or immunoprophylaxis underwent local combined administration of microwave induced hyperthermia and intravesical chemotherapy as a debulking approach. Due to extensive superficial involvement of the bladder walls complete transurethral resection of all tumors seemed technically unfeasible in all cases and radical cystectomy was considered the treatment of choice. Endovesical hyperthermia at 42.5 to 46C was delivered using the SB-TS 101 system, based on a microwave transurethral applicator that irradiates the bladder filled with a circulating solution of mitomycin C. Patients underwent 8 weekly 1-hour sessions on an outpatient basis without anesthesia. When possible, after treatment patients underwent transurethral resection of residual tumors and all suspicious areas. Results: After treatment transurethral resection appeared to be feasible and curative in 16 patients (84%). Histological study revealed complete and partial responses in 9 (47%) and 7 (37%) cases, respectively. Due to extensive residual tumors radical cystectomy was performed in 3 patients (16%). At a median 33-month follow-up 8 superficial transitional tumor recurrences were documented and easily eradicated by transurethral resection or laser therapy in patients in whom the bladder had been saved. Conclusions: Microwave induced hyperthermia combined with intravesical mitomycin C seems to be a feasible, safe and elective approach for conservative treatment of multifocal and recurrent superficial bladder tumors when other treatment strategies have failed

Published
1998

14. Neodymium:YAG laser treatment of bladder neck contracture following prostatectomy

Author

Silber N and Servadio C

Subjects
Male, medicine.medical_specialty, Contracture, medicine.medical_treatment, Bladder neck contracture, Urinary Bladder, Dermatology, Light Coagulation, Urethra, Medicine, Humans, Yttrium, Aged, Neodymium, Prostatectomy, medicine.diagnostic_test, business.industry, Cystoscopy, Middle Aged, Urinary Retention, Surgery, Urinary Bladder Neck Obstruction, Neck of urinary bladder, Ambulatory Surgical Procedures, Nd:YAG laser, Neodymium-YAG laser, Aluminum Silicates, medicine.symptom, Complication, business, Urinary Catheterization
Abstract

A total of 21 patients with postprostatectomy bladder neck contracture underwent treatment with Nd:YAG laser irradiation. A new 800-μm hemispherical optical quarz fiber was used in contact technique to produce linear incisions in the scarred tissue. Within 11.2 months, median of follow-up, there was improvement in the obstructive voiding symptoms in all the patients. Two patients who had still mild contracture in the first follow-up cystoscopy were managed successfully with a second treatment. Endoscopic application of laser energy in the contact mode enables the immediate vaporization and disintegration of the fibrous area and secondary reepithelization of the bladder neck without scarring. © 1992 Wiley-Liss, Inc.

Published
1992

38. Abstracts

Author

Rocca Rossetti, S., primary, de Vita, R., additional, Servadio, C., additional, Giuliani, L., additional, Kralić, I., additional, Martelli, A., additional, Pagano, F., additional, Pavon, M., additional, Kury, S., additional, Boccon-Gibod, L., additional, and Pizzocaro, G., additional

Published
1991
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