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Indications Cystitis after radiotherapy for prostatic cancer

Efficacy of sodium hyaluronate in the management of chemical and radiation cystitis Sommariva et al. Minerrva Urol Nefrol 2010. Indications Cystitis after radiotherapy for prostatic cancer

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Indications Cystitis after radiotherapy for prostatic cancer

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  1. Efficacy of sodiumhyaluronate in themanagement of chemical and radiationcystitisSommariva et al. MinerrvaUrolNefrol 2010

  2. Indications • Cystitisafterradiotherapyforprostaticcancer • Cystitis in patientsreceivinginmuno-chemotherapeuticagentsbyintravesicalinjstillationfor non-muscleinvasivetransitionalcell carcinoma of thebladder (BCG orMitomycin C) Poor and Slow response tothe usual symptomatictreatments Thesebladdersymptomsoften mean thatcancertherapy has tobeinterrupted, which has furtherclinicalimplications, liketheimpactonthepossibility of success

  3. Administration of Cystistat • 69 maleconsecutivepatients • 15 afterRadiotherapy (Rxt) • 24 after BCG • 30afterMitomycin C

  4. Administration of Cystistat • Cystistatwasadministeredweeklyfrom 8 to 24 weeks, dependingonhowthyesymptomsreleased. • Lidocaine 2% 30 mLwasinstilled 30 min before, toallowpatientstokeepCystistatwithinthebladder • In thefirst 4 weeks, Dexamethasone 32 mg wasmixedto HA lookingforanantiinflammatoryeffect

  5. Results • – BladderCapacity (BC) • – Visual Analogic Score (VAS) forPain • Afteronly 4 weeks BC increased in allpatients, and Urgency and Painalmostdisappeared. Treatmentwascontinuedhoweverforanother 4 weeks, even in patientswith total remission of theirsymptoms. • Itwasseenpreviouslybytheauthorsthatiftherapystoppedtosoon, thenthesymptomscouldreturn.

  6. ChemicalCystitisgroupRIC groupBTATBTAT VAS 8,6 0,9 NotMeasured • (Frequency + Urgency) • BC BTATBTAT • 58,4 283,7 85,0243,3

  7. 97% reported complete relief of dysuria and pain • No adversereactions, allowingtheconclusion of treatmentsforbladdercancer • Aftertherapy, urinarycitology and cistoscopyruledoutbledderrcancerprogression • Conclusion: • IntravesicalHyaluronan (HA) seems a valid and quicktherapeuticsolutionforiatrogeniccystitisfromchemoorradiotherapy

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