title: Extravasation of intravesical chemotherapy for non-muscle-invasive bladder cancer.
abstract: OBJECTIVE
  To report our experience with symptomatic extravasation of intravesical chemotherapy administered within 24 h after transurethral resection (TUR) over the past 10 years.
  
  
  METHODS
  We identified all consecutive patients who presented with symptomatic extravasation of intravesical chemotherapy following TUR between 2001 and 2011. We assessed the severity of the postoperative complications using the modified Clavien system.
  
  
  RESULTS
  We identified 9 patients (mean age 59, range 40-76 years) with symptomatic extravasation. One patient had grade II, 2 had grade IIIa, and 5 patients had grade IIIb complications according to the Clavien system. Surgery was needed in 6 of 9 patients. One required ICU management (Clavien IV). No patients died in the postoperative course.
  
  
  CONCLUSIONS
  Extravasation can cause severe complications and diagnosis is often protracted. Considering the growing practice of immediate intravesical instillations, the number of patients with symptomatic extravasation is expected to rise. An increased awareness of this possible complication is warranted.
authors.affiliation: Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. mertens@nki.nl
authors.forename: Laura S
authors.initials: LS
authors.lastname: Mertens
authors.forename: Wim
authors.initials: W
authors.lastname: Meinhardt
authors.forename: Walther B
authors.initials: WB
authors.lastname: Rier
authors.forename: Ronald I
authors.initials: RI
authors.lastname: Nooter
authors.forename: Simon
authors.initials: S
authors.lastname: Horenblas
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods