Background: Mitomycin C (MMC) extravasation after transurethral resection of bladder tumor (TURBT) is a rare and highly morbid complication. Management of these cases may require a multidisciplinary approach with strategies ranging from conservative management to surgical intervention. Case Presentation: We present a 48-year-old woman who received a TURBT for a 5 mm bladder tumor. Procedure was uneventful and no bladder perforation was noticed. A single dose of instillation of MMC was performed after surgery resulting in extravasation, consequent ipsilateral pudendal neuralgia, and ureterohydronephrosis. Treatment included a second TURBT, Double-J stent placement, and multiple pain management schemes. After 8 months the patient had complete resolution of pain and ureterohydronephrosis. Conclusion: Perioperative chemotherapy is the standard of care in low-risk bladder cancer. Extravasation of MMC, although rare, can produce severe complications, sometimes irreversible. Other treatment options, such as gemcitabine, are less frequently used despite being less irritant and having similar efficacy. Further studies are needed to compare single-dose instillation regimens. Copyright 2020, Mary Ann Liebert, Inc., publishers.
Background: Mitomycin C (MMC) extravasation after transurethral resection of bladder tumor (TURBT) is a rare and highly morbid complication. Management of these cases may require a multidisciplinary approach with strategies ranging from conservative management to surgical intervention. Case Presentation: We present a 48-year-old woman who received a TURBT for a 5 mm bladder tumor. Procedure was uneventful and no bladder perforation was noticed. A single dose of instillation of MMC was performed after surgery resulting in extravasation, consequent ipsilateral pudendal neuralgia, and ureterohydronephrosis. Treatment included a second TURBT, Double-J stent placement, and multiple pain management schemes. After 8 months the patient had complete resolution of pain and ureterohydronephrosis. Conclusion: Perioperative chemotherapy is the standard of care in low-risk bladder cancer. Extravasation of MMC, although rare, can produce severe complications, sometimes irreversible. Other treatment options, such as gemcitabine, are less frequently used despite being less irritant and having similar efficacy. Further studies are needed to compare single-dose instillation regimens. Copyright 2020, Mary Ann Liebert, Inc., publishers.
Authors: Edward M Messing; Catherine M Tangen; Seth P Lerner; Deepak M Sahasrabudhe; Theresa M Koppie; David P Wood; Philip C Mack; Robert S Svatek; Christopher P Evans; Khaled S Hafez; Daniel J Culkin; Timothy C Brand; Lawrence I Karsh; Jeffrey M Holzbeierlein; Shandra S Wilson; Guan Wu; Melissa Plets; Nicholas J Vogelzang; Ian M Thompson Journal: JAMA Date: 2018-05-08 Impact factor: 56.272
Authors: Richard J Sylvester; Willem Oosterlinck; Sten Holmang; Matthew R Sydes; Alison Birtle; Sigurdur Gudjonsson; Cosimo De Nunzio; Kikuo Okamura; Eero Kaasinen; Eduardo Solsona; Bedeir Ali-El-Dein; Can Ali Tatar; Brant A Inman; James N'Dow; Jorg R Oddens; Marek Babjuk Journal: Eur Urol Date: 2015-06-16 Impact factor: 20.096