The authors present the current pharmacological and clinical data concerning EPOI and their practical implications. The importance of performing this instillation during the first 24 hours following TURB appears to be confirmed. EPOI of MMC is accompanied by a 34 to 50% reduction of early recurrences. Data in the literature confirm the low systemic diffusion of MMC and good safety, under certain conditions. Computerized modelling of pharmacological data ensures optimal modalities of MMC instillations. Recent clinical data confirm the value of these measures. In view of the higher early recurrence rate for superficial multifocal and/or recurrent tumours, these modalities could be preferentially indicated in these cases. However, IPOP must be considered cautiously for very large tumours accompanied by deep resection and/or bladder perforation.
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