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Japanese Journal of Clinical Oncology, Vol 29, Issue 10 479-484, Copyright © 1999 by Foundation for Promotion of Cancer Research

ORIGINAL ARTICLE

Lower urinary tract function after intra-arterial chemotherapy with concurrent pelvic radiotherapy for invasive bladder cancer

N Sekido, N Miyanaga, K Kikuchi, H Takeshima and H Akaza
Department of Urology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.

BACKGROUND: Intra-arterial chemotherapy with concurrent pelvic radiotherapy as a bladder-sparing regimen for invasive bladder cancer is highly promising for selected patients. However, lower urinary tract function after this treatment has not been fully investigated. METHODS: The urodynamic effects of intra-arterial chemotherapy with concurrent pelvic radiotherapy were retrospectively evaluated in 14 patients with organ-confined invasive bladder cancer. The post-treatment urodynamic findings were compared with the pretreatment ones (n = 7), and a comparison was made between the serial urodynamic findings after the treatment in another seven patients who were able to undergo the pretreatment urodynamic study (UDS). RESULTS: The median follow-up period up to the latest UDS was 34 months. Of the 14 patients, the latest UDS revealed some storage dysfunctions in 11 (79%) and some emptying dysfunctions in three (23%). Uninhibited detrusor contraction and decreased bladder compliance were recorded in 29 and 43% at the pretreatment UDS and approximately 50-60 and 20-60% in the serial follow-up studies, respectively (n = 7). Impaired detrusor contractility lasted in one patient. In the seven patients without the pretreatment UDS, decreased maximum cystometric capacity and decreased compliance were recorded in approximately 50-60 and 20-60% at the serial UDS, respectively. Detrusor contractility was aggravated in one patient and completely lost in one with time. CONCLUSIONS: The urodynamic findings indicate that the bladder-sparing regimen might result in perpetuating the lower urinary tract dysfunctions due to invasive bladder cancer itself and/or transurethral surgery and might injure the infrasacral autonomic nerves and the bladder itself.
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N. Miyanaga, H. Akaza, S. Hinotsu, A. Joraku, T. Oikawa, N. Sekido, K. Kawai, and T. Shimazui
Background Variables for the Patients with Invasive Bladder Cancer Suitable for Bladder-preserving Therapy
Jpn. J. Clin. Oncol., November 1, 2007; 37(11): 852 - 857.
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