532 INCREASING DWELL TIME OF MITOMYCIN C IN THE UPPER TRACT WITH A REVERSE THERMOSENSITIVE POLYMER (2013)

You have accessJournal of UrologyUrothelial Cancer: Medical & Surgical Therapy1 Apr 2013532 INCREASING DWELL TIME OF MITOMYCIN C IN THE UPPER TRACT WITH A REVERSE THERMOSENSITIVE POLYMER Zachariah Goldsmith, Agnes Wang, Andreas Neisius, Olugbemisola Oredein-Mccoy, Muhammad Iqbal, Gaston Astroza, Ramy Youssef, Nicholas Kuntz, W. Neal Simmons, Michael Lipkin, Glenn Preminger, and Michael Ferrandino Zachariah GoldsmithZachariah Goldsmith DURHAM, NC More articles by this author , Agnes WangAgnes Wang DURHAM, NC More articles by this author , Andreas NeisiusAndreas Neisius DURHAM, NC More articles by this author , Olugbemisola Oredein-MccoyOlugbemisola Oredein-Mccoy DURHAM, NC More articles by this author , Muhammad IqbalMuhammad Iqbal DURHAM, NC More articles by this author , Gaston AstrozaGaston Astroza DURHAM, NC More articles by this author , Ramy YoussefRamy Youssef DURHAM, NC More articles by this author , Nicholas KuntzNicholas Kuntz DURHAM, NC More articles by this author , W. Neal SimmonsW. Neal Simmons DURHAM, NC More articles by this author , Michael LipkinMichael Lipkin DURHAM, NC More articles by this author , Glenn PremingerGlenn Preminger DURHAM, NC More articles by this author , and Michael FerrandinoMichael Ferrandino DURHAM, NC More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1926AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Topical chemotherapy for urothelial cancer is dependent on adequate contact time of the chemotherapeutic agent with the urothelium. To date, there has not been a reliable method of maintaining this contact for renal or ureteral urothelial carcinoma. We evaluated the safety and feasibility of using a reverse thermosensitive polymer to improve dwell times of Mitomycin C in the upper tract. METHODS Using a porcine model, five animals were treated endoscopically with bilateral upper urinary tracts receiving MMC mixed with iodinated contrast. The treatment side had ureteral outflow blocked with a reverse thermosensitive polymer plug. MMC dwell time was monitored fluoroscopically and intra-renal pressures were measured. Two animals were euthanized immediately, and three animals were euthanized on postoperative day 5. RESULTS In control kidneys, drainage occurred at a mean of 5.3 min. In treatment kidneys, dwell time was extended to 60 minutes in all animals treated ureteroscopically. Intra-renal pressures in the treatment kidneys peaked at 75.0 cm H20 and reached steady-state at 60 cm H20. Pressures normalized following washout of the polymer with cool saline. No histopathological differences were seen between the control and treatment kidneys, or with immediate compared to delayed euthanasia. CONCLUSIONS A reverse thermosensitive polymer can retain MMC in the upper urinary tract for up to 60 minutes and appears to be safe from our examination of intra-renal pressures and histopathology. This technique may improve the efficacy of topical chemotherapy in the management of upper tract urothelial carcinoma. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e218 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zachariah Goldsmith DURHAM, NC More articles by this author Agnes Wang DURHAM, NC More articles by this author Andreas Neisius DURHAM, NC More articles by this author Olugbemisola Oredein-Mccoy DURHAM, NC More articles by this author Muhammad Iqbal DURHAM, NC More articles by this author Gaston Astroza DURHAM, NC More articles by this author Ramy Youssef DURHAM, NC More articles by this author Nicholas Kuntz DURHAM, NC More articles by this author W. Neal Simmons DURHAM, NC More articles by this author Michael Lipkin DURHAM, NC More articles by this author Glenn Preminger DURHAM, NC More articles by this author Michael Ferrandino DURHAM, NC More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...