Mitomycin C for prevention of bladder tumor recurrence

A 30 year old lady presented with history of hematuria and dysuria. There was no history of comorbidities.

There was no history of prior surgical intervention .

On evaluation her USG showed left lateral wall space occupying lesion 3x2 cm and positive urine cytology for malignancy.

She was taken up for Trans-Urethal Bladder tumor resection with Continuous wave Holmium Laser.The Mitomycin C is a 334-kD alkylating agent that inhibits DNA synthesis. The drug is usually instilled weekly for 6 to 8 weeks at dose ranges from 20 to 60 mg.
One review found a 38% reduction in tumor recurrence with MMC.
Optimization of MMC delivery can result in halving of the recurrence rate in some studies. This can be achieved by eliminating residual urine volume, overnight fasting, using sodium bicarbonate to reduce drug degradation, and increasing concentration to 40 mg in 20 mL.