Histopathological effects and recovery rate of rat bladders following intravesical instillation of thiotepa, doxorubicin and mitomycin C

MITOMYCIN C AND EPIRUBICIN: FUNCTIONAL BLADDER DAMAGE IN RATS AFTER REPEAT INTRAVESICAL INSTILLATIONS

PURPOSE

We studied functional damage in the bladder after intravesical administration of mitomycin C or epirubicin in rats.

MATERIALS AND METHODS

A total of 40 rats were divided into 4 groups. Rats in 3 groups received intravesical instillations of mitomycin C, epirubicin or saline. Rats in group 4 received no intravesical instillations and served as normal controls. The doses of drugs administered were based on those used for therapeutic purposes. Changes in vesical capacity and bladder wall compliance were determined. Compliance was defined as the change in vesical volume induced by a given change in pressure.

RESULTS

Weekly instillations of 1 mg/ml mitomycin C caused a statistically significant decrease in vesical volume and compliance, which persisted 3 weeks after the cessation of therapy. Epirubicin also induced changes in vesical volume and compliance but only that in bladder compliance achieved statistical significance. These changes were not seen in NaCl treated animals or in normal controls.

CONCLUSIONS

Repeat intravesical instillations of mitomycin C have a prolonged effect on bladder function that is not seen after saline solution or epirubicin instillation.

Upper eyelid retraction after glaucoma filtering surgery and topical application of mitomycin C

PURPOSE

To describe 3 cases of upper eyelid retraction after glaucoma filtering surgery and topical application of mitomycin C and to highlight possible causes.

METHODS

A report of 3 patients, identified over an 8-year interval period, who had development of upper eyelid retraction a few months after undergoing trabeculectomy with mitomycin C in the ipsilateral eye.

RESULTS

Testing for Graves disease, including second-generation thyrotropin receptor antibodies (TRAb), was negative in all cases. A complete physical examination was performed by an internist: Orbital and intracranial neuroimaging studies were ordered when necessary, and all were negative. One patient underwent surgical repair of the eyelid retraction and had a satisfactory result.

CONCLUSIONS

Upper eyelid retraction after filtering surgery is a rarely reported entity. Müller muscle overaction, independent of Graves disease, is a likely cause and has been pointed out as a possible factor in one previous report. Müller muscle fibrosis, euthyroid Graves disease, and mechanical hindrance to an elevated bleb are other possible factors.

Bladder wall fibrosis following intravesical mitomycin treatment for superficial bladder cancer

Mitomycin is used extensively for the prevention of recurrence of superficial bladder cancer. Most treatment regimens of mitomycin are long term, since this seems more effective in preventing recurrence. During treatment some patients develop cystitis of variable severity, which may lead to mucosal ulcerations and cessation of treatment. We report a case in which long-term treatment with mitomycin, following a single episode of transitional cell bladder cancer, has led to bladder fibrosis and loss of its function, without evidence of tumor recurrence.