الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
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SUMMARY AND CONCLUSIONS
Most transitional celI bladder tumors are managed nowadys by
transurethral resection. This method of treatment preserves bladder function,
alIows the patient a good quality of life and at the same time wilI spare the
patients the complications of open radical surgery. Treating a patient with a
superficial transitional bladder tumor requires good transurethral resection of
the tumor, the addition of topical chemotherapy or immunotherapy in the
postoperative treatment of superficial transitional bladder cancer has been
found to reduce the recurrence rate and the incidence of progression and to
prolong the disease free interval. BCG was used in treatment of superficial
transitional bladder tumor either given intravesical instillation, intralesions
injection, intradermal injection or oral. In this study we evaluate intravesical
instillation of BCG either given after or before transurethral resection of the
bladder tumors. This study was conducted on (45) patients diagnosed as
superficial bladder tumors whom divided into three groups each included (I 5)
patients. Group (I) in which transurethral resection to the bladder tumors was
the only line of treatment, group (II) in which BCG intravesical instilIation
course (weekly for 6 weeks) was given after transurethral resection to the
bladder tumor and group (III) in which BCG intravesical instillation course
(weekly for 6 weeks) was given after bladder truma such as biopsy, followed
by transurethral resection to the residual tumors. All groups were followed up
cystoscopically and by bladder wash cytology for 24 months.
Both BCG groups were found to be effective than control group in
treatment of superficial transitional bladder tumors, as with BCG groups there
are decrease in the recurrence rate of tumors, delayed appearance of
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recurrence than in control group, and when recurrence has occurred after
BCG groups recurrence with the same stage and grade in high percentage as
the initial tumor presentation, while recurrence with control group presented
with high stage and high grade than the initial tumor presentation.
Also BCG groups were more effective in the presence of bilharziasis
than control group alone. Also BCG groups were more effective on single,
multiple, small and large tumors than control groups.
BCG instillation course when taken after transurethral resection to the
bladder tumor, it is more valid than before transurethral resection and also
more valid when tumor did not infiltrate the lamina propria either small or
large tumor.
BCG intravesical instillation course when given before transurethral
resection, it will make the tumor more smaller and resectable, and there is a
chance of complete disappearance of the tumors.
The complications of BCG was not serous and can be controlled, and
there was no serous complications lead to stop the medications, that was
occurred in group (III) occur, with moderate degree than that in group (II).
In order to obtain good results with BCG either given after or before
transurethral resection to the bladder tumor we follow:
1- Tumors should be candidite to this type of treatment, transitional cell type,
within avarage size and no muscle invasion.