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Indications Cystitis after radiotherapy for prostatic cancer - PowerPoint PPT Presentation


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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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slide1

Efficacy of sodiumhyaluronate in themanagement of chemical and radiationcystitisSommariva et al.

MinerrvaUrolNefrol 2010

slide2

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

slide3

Administration of Cystistat

  • 69 maleconsecutivepatients
  • 15 afterRadiotherapy (Rxt)
  • 24 after BCG
  • 30afterMitomycin C
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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
slide5

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.
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ChemicalCystitisgroupRIC groupBTATBTAT

VAS 8,6 0,9 NotMeasured

  • (Frequency + Urgency)
  • BC BTATBTAT
  • 58,4 283,7 85,0243,3
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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