1.Does every patient with bladder cancer electrosurgery need to have perfusion therapy?
No.
Immediate bladder irrigation: Generally, one bladder irrigation will be performed within 24 hours after electrosurgery (during hospitalization), which is called immediate bladder irrigation. This bladder irrigation is performed unless the patient’s condition is not suitable postoperatively. Low-risk non-muscle-invasive (superficial) bladder cancer is complete with this one perfusion.
Induction bladder perfusion: 1 time/week. Usually 6-8 times for intermediate-to-high risk non-muscle-invasive (superficial) bladder cancer postoperative perfusion.
Maintenance bladder perfusion.
1 time/month. Usually 10-12 times, for a total of 1 year with induction perfusion, with 2 years also reported, less frequently. Some studies between induction and maintenance bladder perfusion have also taken 1 time/2 weeks for 3-4 consecutive weeks of transition. Postoperative perfusion for intermediate – high risk non-muscle invasive (superficial) bladder cancer.
2. Why is perfusion therapy preferred over oral agents?
There are no oral drugs with proven efficacy to prevent bladder cancer recurrence and progression. There is a study underway (whether new oral drugs can prevent bladder cancer recurrence and progression), and our center is involved in it, so patients who cannot tolerate bladder perfusion can try it.
3.Do I still need to do perfusion for invasive bladder cancer?
It is not recommended.
The standard treatment for patients with muscle invasive bladder cancer is radical total cystectomy, and the alternative is also postoperative adjuvant radiotherapy and chemotherapy, and bladder perfusion alone is not enough.
4. Can patients with urethral malformation be treated with perfusion?
Not recommended: Patients with urethral malformation have difficulty in retaining catheterization, and repeated multiple injuries may further lead to urethral stricture. Adjuvant chemotherapy or radiotherapy can be considered, both of which can effectively control recurrence and progression.
5.Does perfusion therapy cause hematuria and painful urination? Does it all cause inflammation?
About 10-25% of patients will experience urinary discomfort during bladder perfusion, and a very small percentage will experience hematuria and significant painful urination. There are several possible causes: 1. injury to the urethra during insertion of the urethra; 2. irritation of the bladder and urethra by medication; 3. bacterial infection due to the operation of the urethral insertion.
The most common cause is drug irritation, usually 1-2 days will improve on its own; if it is a bacterial infection is often difficult to get better on its own, and the symptoms are obvious. Do not force the next bladder irrigation at this time to avoid further aggravation. Urine routine can clearly identify these two cases.
6.Does the inflammation and painful stimulation easily make bladder cancer recur?
No.
7.How to evaluate the effect of perfusion treatment?
Regular cystoscopy and urine exfoliation cytology can effectively evaluate whether bladder cancer recurs after surgery.
8.Will the cancer recur during the perfusion period?
It is possible, especially during the maintenance period, 1 month/time. Cystoscopy performed between perfusions may reveal recurrence, and not every bladder cancer can effectively avoid recurrence.
9.What if I miss a perfusion treatment?
If there is no infection or urinary tract discomfort, it can be made up as early as possible.