Repeated transurethral bladder resections (TURBs) and instillation treatments in non-muscle invasive bladder cancer (NMIBC) might influence bladder function and, therefore, quality of life. Bladder-related medication is a surrogate marker of compromised bladder function. The objective was to investigate whether TURBs and adjuvant instillation therapy are associated with the use of anticholinergics, β3-agonists, and cystitis-relevant antibiotics. We divided all Danish patients diagnosed with primary NMIBC during 2002–2017 registered in the Danish National Patient Registry (DNPR) based on TURB-load within the first five years from diagnosis (1 TURB, 2–4 TURBs, ≥5 TURBs). Instillation therapy with either mitomycin C (MMC) or bacillus Calmette-Guerin vaccine (BCG) was independent exposure (yes or no). We included 17,774 patients; 76% men, median age: 70 years (IQR: 63, 77). Patients exposed to ≥5 TURBs had a higher risk of using bladder-relaxing medication than patients exposed to 1 TURB, HR = 4.01 [3.33; 4.83], and higher risk of cystitis, HR = 2.27 [2.05; 2.51]. BCG-exposed patients had a higher risk of bladder-relaxing medication use compared to non-exposed, HR = 1.92 [1.69; 2.18], and a higher risk of cystitis, HR = 1.39 [1.31; 1.48]. Repeated TURBs have the highest impact on bladder function. Adjuvant instillation therapy is also associated with the use of bladder-related medication.
非肌层浸润性膀胱癌（NMIBC）患者接受反复经尿道膀胱肿瘤切除术（TURB）及灌注治疗可能影响膀胱功能，进而降低生活质量。膀胱相关药物的使用是膀胱功能受损的替代标志物。本研究旨在探讨TURB及辅助灌注治疗是否与抗胆碱能药物、β3受体激动剂及膀胱炎相关抗生素的使用存在关联。我们基于丹麦国家患者登记系统（DNPR）中2002-2017年确诊的原发性NMIBC患者数据，根据诊断后五年内接受的TURB次数进行分组（1次、2-4次、≥5次）。灌注治疗（丝裂霉素C或卡介苗）作为独立暴露因素（是/否）。共纳入17,774例患者，其中男性占76%，中位年龄70岁（四分位距：63-77岁）。接受≥5次TURB的患者相较于仅接受1次TURB者，使用膀胱松弛药物的风险更高（风险比HR=4.01[3.33;4.83]），膀胱炎发生风险也更高（HR=2.27[2.05;2.51]）。接受卡介苗灌注治疗的患者较未接受者，使用膀胱松弛药物的风险更高（HR=1.92[1.69;2.18]），膀胱炎风险亦更高（HR=1.39[1.31;1.48]）。结论：反复TURB对膀胱功能影响最为显著，辅助灌注治疗同样与膀胱相关药物的使用存在关联。
Use of Bladder-Related Medication in Non-Muscle Invasive Bladder Cancer Patients
肿瘤(癌症)患者之家