Evaluation of Helmstein's Distension Method for Carcinoma of the Bladder

England, H. R.; Rigby, C. C.; Shepheard, B. G. F.; Tresidder, G. C.; Blandy, J. P.

doi:10.1111/j.1464-410x.1973.tb12228.x

Cited by 38 publications

(6 citation statements)

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“…In a study on 49 patients treated for urothelial carcinoma using hydrostatic bladder distention, England et al . reported a 100% success rate of hemostasis in nine patients with gross hematuria . Likewise, Hammonds et al .…”

Section: Resultsmentioning

confidence: 92%

Therapeutic options for intractable hematuria in advanced bladder cancer

et al. 2013

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Abbreviations & AcronymsAbstract: Intractable hematuria is a common and severe complication in patients with inoperable bladder carcinoma. The aim was to provide an overview of therapeutic options for such cases, and analyze their effectiveness and risk profile, so a systematic literature search of peer-reviewed papers published up to September 2012 was carried out. Various options are available to treat hematuria in patients with inoperable bladder cancer; these include orally administered epsilon-aminocaproic acid, intravesical formalin, alum or prostaglandin irrigation, hydrostatic pressure, urinary diversion, radiotherapy, embolization and intraarterial mitoxantrone perfusion. These treatment options are associated with different prospects of success, risks and side-effects. Well-designed and large studies comparing options are completely lacking. Despite various treatment options, management of intractable hematuria in patients with inoperable bladder cancer remains a challenge, and most of the reported methods should be seen as experimental. Interventional radiology and alum instillation seem to be suitable alternative options for patients who, after critical consideration, cannot be treated by irrigation, transurethral resection or palliative cystectomy.

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Section: Resultsmentioning

confidence: 92%

Therapeutic options for intractable hematuria in advanced bladder cancer

et al. 2013

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“…Highly toxic, high rate of complications, systemic toxicity D 3 (Shrom et al, 1976;Redman & Kletzel, 1994;Cheuk et al, 2007) Silver nitrate Instillation (Helmstein, 1972;England et al, 1973;Hammonds et al, 1974;Hansen et al, 1976) Cystostomy/ cystectomy (Ordemann et al, 2000). Side effects were rare, although cases of hepatosis requiring treatment withdrawal have been reported (Ordemann et al, 2000).…”

Section: Cessation Of Bleeding Probably Effectivementioning

confidence: 99%

Prevention and management of BK‐virus associated haemorrhagic cystitis in children following haematopoietic stem cell transplantation – a systematic review and evidence‐based guidance for clinical management

et al. 2008

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SummaryHaemorrhagic cystitis (HC) is a common and, in its severe form, potentially life-threatening complication of Haematopoietic stem cell transplantation (HSCT) in children. Recent data indicate an important role of BK virus reactivation during the time of maximal post-transplant immune suppression in the pathogenesis of late-onset HC. Treatment of HC is mainly symptomatic and often frustrating. To give clinicians guidance on prevention and treatment options and their backing by scientific evidence, we have systematically assessed the available literature and devised evidence-based guidelines. Our comprehensive review demonstrates that evidence for the most commonly used interventions (such as cidofovir, oestrogen, hyperbaric oxygen, bladder instillation with formalin, alum salts or prostaglandin) is very limited. Some of these interventions also carry significant risks. Higher level evidence exists only for 2-mercaptoethane sodium (MESNA) and hyperhydration as a preventative intervention, and for systemic recombinant Factor VII as a treatment to stop acute haemorrhage. Further high-quality studies are required to establish effective and safe prevention and treatment options for HC.

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“…England et al [16] evaluated Helmstein's method for the treatment of bladder carcinoma in a study of 49 patients; in nine patients whose major problem was uncontrollable bleeding (six from tumour and three from post‐radiation necrosis) all were controlled immediately. Those who bled from post‐radiation cystitis did not have recurrent bleeding and in those who bled from tumour, two had no further bleeding at 6 months, two had successful further distensions at 6 and 8 months, one underwent cystectomy at 4 months and one died at 4 months with no recurrence.…”

Section: Intravesical Helmstein's Hydrostatic Pressurementioning

confidence: 99%

“…The most common serious side‐effect of hydrodistension was rupture of the bladder, which could be either partial or total. In his first 13 treatments, Helmstein described two total ruptures and one perforation through an ulcerated tumour; others have reported ruptured bladder [10,16]. The occurrence of perforation could be predicted by a sudden increase in the drip‐rate of the infused normal saline.…”

Section: Intravesical Helmstein's Hydrostatic Pressurementioning

confidence: 99%

“…Deaths after the procedure have been reported but not directly attributed to the treatment. An elderly patient in heart failure had an extension of a recent myocardial infarction [16] and another two patients died from pulmonary embolism within 3 days of the procedure [10]. The most common minor complications included nausea and vomiting, temporary incontinence [12], severe abdominal pain that settled spontaneously [14] and pyrexia [10,12,14].…”

Section: Intravesical Helmstein's Hydrostatic Pressurementioning

confidence: 99%

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