腺性膀胱炎术后大剂量丝裂霉素膀胱灌注疗效分析(附65例报告)

Analysis of efficacy of bladder irrigation with mitomycin-c at high dose after surgery in cystitis glandularis

目的 提高腺性膀胱炎综合治疗效果。 方法 腺性膀胱炎患者 6 5例 ,膀胱镜检表现为滤泡样或绒毛样 39例、乳头瘤样 15例、慢性炎症 8例、无明显改变 3例。经尿道电切或膀胱部分切除术后大剂量丝裂霉素 (4 0mg/次 )膀胱灌注 ,规律治疗 2年 ,方案为每周 1次共 8次 ,其后每月 1次共10次 ,第 2年每 3个月 1次。定期做膀胱镜检查 ,并行组织学观察。 结果 随访 7～ 72个月 ,平均2 9个月。 6 0例痊愈 ,膀胱黏膜逐渐恢复为移行上皮覆盖 ;4例复发 ;1例腺癌变。 结论 经尿道电切或电灼 ,术后大剂量丝裂霉素灌注治疗腺性膀胱炎 ,有助于膀胱上皮的组织学转归。

Objective To evaluate the comprehensive treatment results of cystitis glandularis. Methods A total of 65 cases of cystitis glandularis underwent cystoscopy.The results showed follicular or villous changes in 39 cases,papillomatous in 15,chronic inflammation in 8 and no obvious change in 3.Transurethral electric resection or partial cystectomy were performed.After surgery all the cases received mitomycin-c bladder irrigation at high dose (40 mg once) regularly for 2 years.During the follow-up cystoscopy was periodically performed and the biopsy samples were pathologically examined with all the cases. Results The mean follow-up was 29 months (range,7 to 72 months).Of the 65 cases,60 fully recovered with transitional cell surface covering the bladder musoca gradually;4 had relapse;and 1 developed canceration (adenocarcinoma). Conclusions Transurethral resection of bladder tumors or galvanocautery is the essential therapy for cystitis glandularis.After surgery the bladder irrigation with mitomycin-c at high dose can be helpful for urothelium recover in histology.