With a yearly incidence of nearly 550,000 (worldwide), bladder cancer is the 6th most common cancer in men and the 17th most common in women.1 In the non-muscle invasive (superficial) form of the disease intravesical instillation is an effective method of reducing recurrence; the two most frequently used drugs are BCG (Bacillus Calmette-Guérin) and mitomycin.2,3. Gemcitabine and valrubicin are less commonly used: the former one is less efficient but causes less side effects, the latter one may be applied if the patient has not responded to BCG. The therapy usually lasts for six weeks (one instillation per week), the maintenance therapy thereafter may last for 1–2 years (with less frequent instillations), depending on the pathological staging. It is suggested by some experts that one single instillation after transurethral resection of the bladder might help lower the chance of recurrence.4
Theoretically, performing the local chemotherapy with the UroDapter® would be beneficial because the drug would affect the urethra, too, where neoimplantation of tumorous cells could occur. Further clinical trials are needed to certificate this indication.
Practically, in male patients there is an issue that must be pointed out. In case the urethral pressure is high, the drug may enter the spermatic cord and reach the gonads, too. To assess the risks and the precise effect of the chemotherapeutic drugs on the gonads further research is needed. On the other hand, UroDapter® may be used in women: because of their different anatomy similar issues shall not emerge.