Abstract

Radical cystectomy is one of the suggested treatment approach due to high recurrence rates in patients with unresectable superficial bladder cancers. However losting their bladder and accepting the suggested diversion methods of patients are difficult for the patients. This situation cause the patients to escape from the medical centers. The recurrence, progretion and patient satisfaction after transurethral resection of the bladder tumor (TUR-BT) and intravesical immunotheraphy were researched in followable patients with unresectable superficial bladder tumors in this study. Between February 1996-March 2001, 11 patients aged 45 to 76 years (average age 63 years), with bladder tumor were included in the study. Followings were performed for the patients; abdominal ultrasonography, pelvic tomography, lung graphy and urography, In all of the patients there was either a multifocal ora single papillary tumor totally or partially fillingjhe bladder. During urography none of the patients had upper urinary system dilatation. Perivesical and vesico-rectal areas were clean on the pelvic tomography. There was not any metastasis to the distant organs recorded during lung graphy and abdominal tomography. Patients were informed about the treatment alternatives and their outcomes. Two consecutive total TUR-BTs were performed to the patients with 20 days of intervals. There was no invasion of the muscle in any of the patients. We were informed that in one of the patients tumor was close to the muscle on the surface. In all patients, intravesical BCG immunization once a week for 6 weeks was started 10 days after the first operation. After the 6lh week it was repeated once a month for one year. The follow-up periods were between 6 to 55 months (average 35 months). While five patients did not have any recurrence during the follow-up periods, the remaining 6 patients had 2 to 5 recurrences. Recurrences were identified during the 3rd month cystoscopies and TUR was performed. Patients are still being followed up and they do not have regional or distant organ metastasis.