Introduction

The effectiveness of intravesical irrigation with physiological saline solution or distilled water for prevention of bladder carcinoma recurrence in upper urinary tract urothelial carcinoma (UUT-UC) was examined.

Methods

The study involved UUT-UC patients without distant metastasis who underwent laparoscopic nephroureterectomy from 2001 to 2014. Those who had a history of bladder carcinoma, had undergone neoadjuvant therapy and had bladder carcinoma confirmed before surgery were excluded. Cases that did and did not involve intravesical irrigation were compared for bladder carcinoma recurrence rates within 2 years after surgery. Physiological saline solution or distilled water was used for irrigation, which was performed only during surgery.

Results

Irrigation was performed in 48 (distilled water, 26 cases; physiological saline solution, 22 cases) of the 74 cases in our study. Bladder carcinoma recurrence was observed in 25 patients within 2 years. Comparison between the irrigation and non-irrigation groups revealed that recurrence rates were significantly lower in the irrigation group (irrigation group vs non-irrigation group: 25.0% vs 50.0%, HR0.29, P=0.013). No significant difference in recurrence rate were observed based on the type of irrigation (P=0.96). No adverse event was confirmed in the irrigation group. On multivariate analysis, irrigation was the independent predictive factor involved in the prevention of recurrence (HR0.32, P= 0.0075).

Conclusions

Intravesical irrigation during laparoscopic nephroureterctomy may be a useful option in preventing postoperative bladder carcinoma recurrence in UUT-UC.

Funding

none