Intravesical Mitomycin C –Therapy

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A Local anaesthetic gel is administered as for a Urethral Catheterisation procedure
This is done under a sterile procedure.
A 14-16 Fr Indwelling Catheter is placed into your bladder.
The pre-made-up Mitomycin solution is installed using strict administering criteria
Usually, 2 vials of 20mg MMC is mixed with Saline to a 50cc volume. You require 40mg.
The catheter is then removed
The MMC is required to stay in your bladder for 1 hour.
Body rotation is not required.
WARNING: Any Fevers require urgent attention

Some local discomfort may be experienced.
Your voiding nature will change within the next week
You may experience some urinary frequency
You could develop a fever requiring urgent attention.
Some patients may experience severe pain when/ if the tumour was resected very deep.

NB! Each person is unique and for this reason, symptoms may vary

Side–effects

This will be done every week for 6 weeks
6 weeks after this a check Flexible Cystoscopy will be scheduled as part of your surveillance protocol for your Urothelial carcinoma
This may be repeated.

Surveillance Protocol for Superficial Urothelial Carcinoma

Low Grade: Ta, T1 (G1, G2), CIS

· Initially 3 months after the first resection

· If clear then 9months

· Then annually

High-Risk Low Grade: T1G3 with/out CIS, high volume disease

· This disease may be best treated with a Radical cystectomy

· 3 monthly Check Cystsocopy for 12 months

· If clear, then 6 monthly for a further 12 months

· If clear then annually for 5-7 years

· My recommendation thereafter would be a 2-yearly cystoscopy with intermittent Urine Cytology

· You fall back to the beginning with any recurrences

· Please don’t hesitate to direct all further queries to Dr. Schoeman’s rooms.