A 45 year old man was referred for urological evaluation following an episode of aymptomatic microscopic hematuria. He had no preceeding LUTS and no burning micturition. He was a non smoker.
Physical examination was unremarkable.
Renal function and hemogram was within normal limits.
CECT urogram was suggestive of a bladder wall thickening/growth on the posterior wall of bladder.
Cystoscopy revealed a solitary papillary growth over the trigone. The tumour was resected transurethrally.
Mitomycin (80mg) was instilled postoperatively.
Histopathology revealed TaG1 lesion.
Discussion: Mitomycin C has been shown to decrease recurrence in superficial bladder tumours. But the results are disputed and presently percieved to be beneficial mainly in decreasing early recurrences (within 2 years) in low grade solitary superficial tumours.
Instillation within 24 h has been shown to be superior to an instillation 2 wk after TURBT in a multicentre study.
Mitomycin C used sequentially with BCG reduces relapse compared with BCG alone in intermediate and high risk tumours. The combination may be used in recurrent T1 tumors but at the cost of increased toxicity. Electromotive instillation of Mitomycin C used sequentially with BCG has also been of benefit in a similar setting.
Extravasation has been reported after intravesical instillation. This may rarely manifest with pelvic pain due to perivesical soft tissue injury and required surgical debridement.