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Ureteral complications after intravesical formalin instillation
The Journal of Urology
|August 1, 1979
Summary
Formalin therapy effectively stops bleeding from post-radiation cystitis. However, high complication rates, including anuria and kidney injury, necessitate revised treatment protocols for patient safety.
Area of Science:
- Urology
- Oncology
Background:
- Post-radiation cystitis can cause severe bladder hemorrhage.
- Formalin therapy is a treatment option for intractable bleeding.
Observation:
- This study evaluated formalin therapy for 27 patients with post-radiation cystitis.
- Gross bleeding ceased in 25 patients within 48 hours.
Findings:
- Significant ureteral complications occurred, including immediate anuria in 5 patients and transient creatinine increases in 7.
- Urinary diversion was required in 11 patients, a higher rate than previously reported.
- Complications may stem from vesicoureteral reflux of a concentrated formalin-alcohol solution.
Implications:
- Revised protocols are crucial to mitigate risks associated with formalin therapy.
- Recommendations include high perioperative diuresis, using 1-2% formalin without alcohol, and limiting instillation pressure to 15 cm water.