title: Intralesional injection of mitomycin C at transurethral incision of bladder neck contracture may offer limited benefit: TURNS Study Group.
abstract: OBJECTIVE
  Injection of mitomycin C may increase the success of transurethral incision of the bladder neck for the treatment of bladder neck contracture. We evaluated the efficacy of mitomycin C injection across multiple institutions.
  
  
  METHODS
  Data on all patients who underwent transurethral incision of the bladder neck with mitomycin C from 2009 to 2014 were retrospectively reviewed from 6 centers in the TURNS. Patients with at least 3 months of cystoscopic followup were included in the analysis.
  
  
  RESULTS
  A total of 66 patients underwent transurethral incision of the bladder neck with mitomycin C and 55 meeting the study inclusion criteria were analyzed. Mean ± SD patient age was 64 ± 7.6 years. Dilation or prior transurethral incision of the bladder neck failed in 80% (44 of 55) of patients. Overall 58% (32 of 55) of patients achieved resolution of bladder neck contracture after 1 transurethral incision of the bladder neck with mitomycin C at a median followup of 9.2 months (IQR 11.7). There were 23 patients who had recurrence at a median of 3.7 months (IQR 4.2), 15 who underwent repeat transurethral incision of the bladder neck with mitomycin C and 9 of 15 (60%) who were free of another recurrence at a median of 8.6 months (IQR 8.8), for an overall success rate of 75% (41 of 55). Incision with electrocautery (Collins knife) was predictive of success compared with cold knife incision (63% vs 50%, p=0.03). Four patients experienced serious adverse events related to mitomycin C and 3 needed or are planning cystectomy.
  
  
  CONCLUSIONS
  The efficacy of intralesional injection of mitomycin C at transurethral incision of the bladder neck was lower than previously reported and was associated with a 7% rate of serious adverse events.
authors.affiliation: Department of Surgery, the Center for Reconstructive Urology and Men's Health, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Redshaw
authors.affiliation: Department of Urology, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Broghammer
authors.affiliation: Scott Department of Urology, Baylor College of Medicine, Houston, Texas.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Smith
authors.affiliation: Department of Urology, Harborview Medical Center, University of Washington School of Medicine, Seattle, Washington.
authors.forename: Bryan B
authors.initials: BB
authors.lastname: Voelzke
authors.affiliation: Department of Urology, University of Iowa Carver College of Medicine, Iowa City, Iowa.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Erickson
authors.affiliation: Department of Urology, the Ohio State Medical Center, Columbus, Ohio.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: McClung
authors.affiliation: University of Minnesota Medical School, Minneapolis, Minnesota.
authors.forename: Sean P
authors.initials: SP
authors.lastname: Elliott
authors.affiliation: Department of Urology, Loyola University Chicago, Maywood, Illinois.
authors.forename: Nejd F
authors.initials: NF
authors.lastname: Alsikafi
authors.affiliation: Division of Epidemiology, University of Utah, Salt Lake City, Utah.
authors.forename: Angela P
authors.initials: AP
authors.lastname: Presson
authors.affiliation: Department of Urology, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Aberger
authors.affiliation: Department of Surgery, the Center for Reconstructive Urology and Men's Health, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: James R
authors.initials: JR
authors.lastname: Craig
authors.affiliation: Department of Surgery, the Center for Reconstructive Urology and Men's Health, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: William O
authors.initials: WO
authors.lastname: Brant
authors.affiliation: Department of Surgery, the Center for Reconstructive Urology and Men's Health, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Jeremy B
authors.initials: JB
authors.lastname: Myers
mesh_terms: D000368:Aged; D015653:Cystectomy / Q000379:methods; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D014521:Urethra; D001745:Urinary Bladder Diseases / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*
chemical_list: D016685:Mitomycin
keywords: administration and dosage; contracture; mitomycin; urinary bladder neck obstruction; urinary incontinence