Safety and Therapeutic Effects Analysis of Immediate Chemical Perfusion in Transurethral Bladder Tumor Resection and Transurethral Resection of Prostate

OBJECTIVE To study the affections of lower urinary tract symptoms and tumor recurrent rate of pirarubicin pirarubicin(THP) intravesical instillation after simultaneous transurethral bladder tumor resection(TURBT) and transurethral resection of prostate(TURP) on non muscle-invasive bladder cancer(NMIBC) and benign prostatic hyperplasia(BPH) patients. METHODS Totally 69 patients with NMIBC and BPH caused lower urinary tract obstruction were recruited, and randomly divided into high concentration THP group(n=35) and low concentration THP group(n=34). The scores of international prostate symptom score(IPSS), stimulation score, obstruction score, quality of life(QOL), maximum urinary flow rate(Q_max), post-voiding residual(PVR), prostate volume, prostate specific antigen, volume of bladder cancer were recorded preoperatively. In the high concentration group, THP 30mg/5% glucose-solution(GS) 30mL was perfused within 6 h after operation, while in the low concentration group, THP 30mg/5% GS 50mL was perfused. Each preoperative scoring index, Q_max, PVR and visual analogue scale(VAS) of bladder pain were recorded every week for 4 weeks. Cystoscopy was performed regularly in the both groups to found recur of cancer. RESULTS No statistically significant differences of baseline and surgical indicators were found between the two groups. During the first 4 weeks post-operation, the scores of irritation, obstruction, IPSS, QOL, PVR and VAS declined, while Q_max increased. The stimulation score and IPSS score of the high concentration group were significantly higher than those of the low concentration group at week 1-3(P all <0.05), and there was no significant difference between the two groups at week 4. The VAS score of the high concentration group was significantly higher than that of the low concentration group in 1-2 weeks after operation(P<0.01), and there was no significant difference between the two groups in 3-4 weeks. At the 4th week, there was no significant difference in all indicators between the groups. The median follow-up time of the two groups was 30 months. During the follow-up period, there were 3 cases of tumor recurrence in the high concentration group(8.6%) and 4 cases of tumor recurrence in the low concentration group(11.8%). There was no significant difference in the recurrence rate between the two groups. CONCLUSION Early THP instillation at 30mg/5%GS 30mL causes more serious urinary tract irritation symptoms than 30mg/5%GS 50mL in patients in a few weeks followed by simultaneous TURBT and TURP, but the symptoms can be relieved in the 4th week postoperatively. No difference is found in the recurrence rate between the two groups during follow-up.