Long-term intravesical thiotepa treatment in patients with superficial bladder tumors and vesicoureteral reflux.

We studied the incidence of myelosuppression and renal function in 33 patients treated by repeated resections of bladder tumors and thiotepa instillations for at least 26 months in the presence of vesicoureteral reflux. Of the 33 patients 28 had unilateral and 5 had bilateral reflux. Transient myelosuppression occurred in 5 patients (15.

Upper tract tumours in patients with vesico-ureteral reflux and recurrent bladder tumours.

27 patients with recurrent low-grade, low-stage transitional cell carcinoma (TCC) of the bladder and uni- or bilateral vesico-ureteral reflux were followed for up to 18 years in order to study a possible higher incidence of TCC of the upper tract. None of the patients developed tumours of the upper collecting system during the follow-up period. Routine bladder instillations with Thiotepa may be one explanation of such a finding.

New therapeutic approach in postoperative phytobezoars.

Postoperative phytobezoars (duration from 2 months to 46 years) after surgery for duodenal ulcer disappeared in seven patients, by both x-ray and gastroscopy, on conservative approach aimed at the major role of delayed gastric emptying in phytobezoar formation. During a 3-day period, metoclopramide was given by drip infusion, 40 mg/24 hours, and the patient received only a copious clear diet, with no solid food. In one patient, two courses of treatment were necessary for complete elimination of the phytobezoar.