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Increasing dwell time of mitomycin C in the upper tract with a reverse thermosensitive polymer.

Publication ,  Journal Article
Wang, AJ; Goldsmith, ZG; Neisius, A; Astroza, GM; Oredein-McCoy, O; Iqbal, MW; Simmons, WN; Madden, JF; Preminger, GM; Inman, BA; Lipkin, ME ...
Published in: J Endourol
March 2013

UNLABELLED: Abstract Background and Purpose: 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 (MMC) in the upper tract. MATERIALS AND METHODS: Using a porcine model, four animals were treated ureteroscopically with both upper urinary tracts receiving MMC mixed with iodinated contrast. One additional animal received MMC percutaneously. The treatment side had ureteral outflow blocked with a reverse thermosensitive polymer plug. MMC dwell time was monitored fluoroscopically and intrarenal pressures measured. Two animals were euthanized immediately, and three animals were euthanized 5 days afterward. RESULTS: In control kidneys, drainage occurred at a mean of 5.3±0.58 minutes. Intrarenal pressures stayed fairly stable: 9.7±14.0 cm H20. In treatment kidneys, dwell time was extended to 60 minutes, when the polymer was washed out. Intrarenal pressures in the treatment kidneys peaked at 75.0±14.7 cm H20 and reached steady state at 60 cm H20. Pressures normalized after washout of the polymer with cool saline. Average washout time was 11.8±9.6 minutes. No histopathologic differences were seen between the control and treatment kidneys, or with immediate compared with delayed euthanasia. CONCLUSIONS: A reverse thermosensitive polymer can retain MMC in the upper urinary tract and appears to be safe from our examination of intrarenal pressures and histopathology. This technique may improve the efficacy of topical chemotherapy in the management of upper tract urothelial carcinoma.

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Published In

J Endourol

DOI

EISSN

1557-900X

Publication Date

March 2013

Volume

27

Issue

3

Start / End Page

288 / 293

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Ureter
  • Time Factors
  • Temperature
  • Sus scrofa
  • Pressure
  • Polymers
  • Mitomycin
  • Kidney
  • Fluoroscopy
 

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Wang, A. J., Goldsmith, Z. G., Neisius, A., Astroza, G. M., Oredein-McCoy, O., Iqbal, M. W., … Ferrandino, M. N. (2013). Increasing dwell time of mitomycin C in the upper tract with a reverse thermosensitive polymer. J Endourol, 27(3), 288–293. https://doi.org/10.1089/end.2012.0211
Wang, Agnes J., Zachariah G. Goldsmith, Andreas Neisius, Gaston M. Astroza, Olugbemisola Oredein-McCoy, Muhammad W. Iqbal, W Neal Simmons, et al. “Increasing dwell time of mitomycin C in the upper tract with a reverse thermosensitive polymer.J Endourol 27, no. 3 (March 2013): 288–93. https://doi.org/10.1089/end.2012.0211.
Wang AJ, Goldsmith ZG, Neisius A, Astroza GM, Oredein-McCoy O, Iqbal MW, et al. Increasing dwell time of mitomycin C in the upper tract with a reverse thermosensitive polymer. J Endourol. 2013 Mar;27(3):288–93.
Wang, Agnes J., et al. “Increasing dwell time of mitomycin C in the upper tract with a reverse thermosensitive polymer.J Endourol, vol. 27, no. 3, Mar. 2013, pp. 288–93. Pubmed, doi:10.1089/end.2012.0211.
Wang AJ, Goldsmith ZG, Neisius A, Astroza GM, Oredein-McCoy O, Iqbal MW, Simmons WN, Madden JF, Preminger GM, Inman BA, Lipkin ME, Ferrandino MN. Increasing dwell time of mitomycin C in the upper tract with a reverse thermosensitive polymer. J Endourol. 2013 Mar;27(3):288–293.
Journal cover image

Published In

J Endourol

DOI

EISSN

1557-900X

Publication Date

March 2013

Volume

27

Issue

3

Start / End Page

288 / 293

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Ureter
  • Time Factors
  • Temperature
  • Sus scrofa
  • Pressure
  • Polymers
  • Mitomycin
  • Kidney
  • Fluoroscopy