title: Neomycin-induced perception deafness following bladder irrigation in patients with end-stage renal disease.
abstract: OBJECTIVE
  To report a serious side-effect of intravesical instillations of neomycin in patients with end-stage renal disease.
  
  
  METHODS
  Three patients (two men and a woman, aged 51.71 and 54 respectively) with end-stage renal disease who had undergone bladder irrigation with neomycin sulphate solution suffered complete irreversible deafness, which was assessed by audiogram.
  
  
  RESULTS
  All three patients developed complete perception deafness after 3, 4 and 10 months, with characteristic changes in the audiogram. The severe progressive hearing loss was maximal in the high-frequency range. A high-pitched tinnitus was the first sign of impending hearing difficulty and two patients developed a spontaneous nystagmus.
  
  
  CONCLUSIONS
  In view of the doubtful efficacy and, most importantly, the risk of severe disabling side-effects such as ototoxicity, we recommend the avoidance of intravesical instillation with neomycin whenever possible.
authors.affiliation: Department of Urology, Philipps-University Medical School, Marburg, Germany.
authors.forename: E W
authors.initials: EW
authors.lastname: Gerharz
authors.forename: K
authors.initials: K
authors.lastname: Weingärtner
authors.forename: M D
authors.initials: MD
authors.lastname: Melekos
authors.forename: S
authors.initials: S
authors.lastname: Varga
authors.forename: H
authors.initials: H
authors.lastname: Feiber
authors.forename: H
authors.initials: H
authors.lastname: Riedmiller
mesh_terms: D000283:Administration, Intravesical; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003638:Deafness / Q000139:chemically induced*; D005260:Female; D006316:Hearing Loss, High-Frequency / Q000139:chemically induced; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009355:Neomycin / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D009355:Neomycin