Intralesional injection of mitomycin C at transurethral incision of bladder neck contracture may offer limited benefit: TURNS study group

Jeffrey D. Redshaw, Joshua A. Broghammer, Thomas G. Smith, Bryan B. Voelzke, Bradley A. Erickson, Christopher D. McClung, Sean P. Elliott, Nejd F. Alsikafi, Angela P. Presson, Michael E. Aberger, James R. Craig, William O. Brant, Jeremy B. Myers

Research output: Contribution to journalArticlepeer-review

50 Scopus citations

Abstract

Purpose Injection of mitomycin C may increase the success of transurethral incision of the bladder neck for the treatment of bladder neck contracture. We evaluated the efficacy of mitomycin C injection across multiple institutions. Materials and Methods Data on all patients who underwent transurethral incision of the bladder neck with mitomycin C from 2009 to 2014 were retrospectively reviewed from 6 centers in the TURNS. Patients with at least 3 months of cystoscopic followup were included in the analysis. Results A total of 66 patients underwent transurethral incision of the bladder neck with mitomycin C and 55 meeting the study inclusion criteria were analyzed. Mean ± SD patient age was 64 ± 7.6 years. Dilation or prior transurethral incision of the bladder neck failed in 80% (44 of 55) of patients. Overall 58% (32 of 55) of patients achieved resolution of bladder neck contracture after 1 transurethral incision of the bladder neck with mitomycin C at a median followup of 9.2 months (IQR 11.7). There were 23 patients who had recurrence at a median of 3.7 months (IQR 4.2), 15 who underwent repeat transurethral incision of the bladder neck with mitomycin C and 9 of 15 (60%) who were free of another recurrence at a median of 8.6 months (IQR 8.8), for an overall success rate of 75% (41 of 55). Incision with electrocautery (Collins knife) was predictive of success compared with cold knife incision (63% vs 50%, p=0.03). Four patients experienced serious adverse events related to mitomycin C and 3 needed or are planning cystectomy. Conclusions The efficacy of intralesional injection of mitomycin C at transurethral incision of the bladder neck was lower than previously reported and was associated with a 7% rate of serious adverse events.

Original languageEnglish (US)
Pages (from-to)587-592
Number of pages6
JournalJournal of Urology
Volume193
Issue number2
DOIs
StatePublished - Feb 1 2015

Keywords

  • administration and dosage
  • contracture
  • mitomycin
  • urinary bladder neck obstruction
  • urinary incontinence

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