Primary localized amyloidosis of the bladder: Experience with dimethyl sulfoxide therapy

Reza S. Malek, Dietlind L. Wahner-Roedler, Morie Gertz, Robert A. Kyle

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Purpose: We present our long-term experience with intravesical dimethyl sulfoxide (DMSO) for primary localized amyloidosis of the bladder. Materials and Methods: The study included 4 males and 2 females 28 to 68 years old (mean age 54) at diagnosis of biopsy proven primary localized amyloidosis involving the bladder diffusely or extensively in 1 locale. All patients had normal upper urinary tracts. They continued to be symptomatic (hematuria in 3, irritative voiding symptoms in 1, and hematuria and irritative voiding symptoms in 2) despite conventional transurethral destructive therapy. Every 2 weeks they received 30-minute instillations of 50 ml. 50% DMSO intravesically for 3 months (patient 1), 6 months (1) and 1 year (4). Results: Therapy failed at 3 and 6 months in 2 patients of whom 1 with a contracted bladder underwent cystectomy and another was stabilized for 1 year with laser therapy. In the remaining 4 patients who were followed for 6 years disease stabilized for 2 to 6 years (mean 3.5) but 3 later required additional therapy including repeat DMSO in 1 and laser therapy in 2. Conclusions: Diffuse or locally extensive bladder involvement by primary localized amyloidosis usually fails to respond to conventional transurethral destructive surgical procedures. Collectively, our experience and the literature suggest that intravesical DMSO can be a bladder saving measure and help resolve ureterovesical obstruction in some patients. High recurrence rate mandates lifelong cystoscopic surveillance.

Original languageEnglish (US)
Pages (from-to)1018-1020
Number of pages3
JournalJournal of Urology
Volume168
Issue number3
StatePublished - Sep 2002

Fingerprint

Dimethyl Sulfoxide
Urinary Bladder
Laser Therapy
Hematuria
Therapeutics
Cystectomy
Urinary Tract
Primary amyloidosis
Biopsy
Recurrence

Keywords

  • Amyloidosis
  • Bladder
  • Dimethyl sulfoxide

ASJC Scopus subject areas

  • Urology

Cite this

Malek, R. S., Wahner-Roedler, D. L., Gertz, M., & Kyle, R. A. (2002). Primary localized amyloidosis of the bladder: Experience with dimethyl sulfoxide therapy. Journal of Urology, 168(3), 1018-1020.

Primary localized amyloidosis of the bladder : Experience with dimethyl sulfoxide therapy. / Malek, Reza S.; Wahner-Roedler, Dietlind L.; Gertz, Morie; Kyle, Robert A.

In: Journal of Urology, Vol. 168, No. 3, 09.2002, p. 1018-1020.

Research output: Contribution to journalArticle

Malek, RS, Wahner-Roedler, DL, Gertz, M & Kyle, RA 2002, 'Primary localized amyloidosis of the bladder: Experience with dimethyl sulfoxide therapy', Journal of Urology, vol. 168, no. 3, pp. 1018-1020.
Malek, Reza S. ; Wahner-Roedler, Dietlind L. ; Gertz, Morie ; Kyle, Robert A. / Primary localized amyloidosis of the bladder : Experience with dimethyl sulfoxide therapy. In: Journal of Urology. 2002 ; Vol. 168, No. 3. pp. 1018-1020.
@article{e3b02f5db72c43ce80d9b6aa8b58e9b6,
title = "Primary localized amyloidosis of the bladder: Experience with dimethyl sulfoxide therapy",
abstract = "Purpose: We present our long-term experience with intravesical dimethyl sulfoxide (DMSO) for primary localized amyloidosis of the bladder. Materials and Methods: The study included 4 males and 2 females 28 to 68 years old (mean age 54) at diagnosis of biopsy proven primary localized amyloidosis involving the bladder diffusely or extensively in 1 locale. All patients had normal upper urinary tracts. They continued to be symptomatic (hematuria in 3, irritative voiding symptoms in 1, and hematuria and irritative voiding symptoms in 2) despite conventional transurethral destructive therapy. Every 2 weeks they received 30-minute instillations of 50 ml. 50{\%} DMSO intravesically for 3 months (patient 1), 6 months (1) and 1 year (4). Results: Therapy failed at 3 and 6 months in 2 patients of whom 1 with a contracted bladder underwent cystectomy and another was stabilized for 1 year with laser therapy. In the remaining 4 patients who were followed for 6 years disease stabilized for 2 to 6 years (mean 3.5) but 3 later required additional therapy including repeat DMSO in 1 and laser therapy in 2. Conclusions: Diffuse or locally extensive bladder involvement by primary localized amyloidosis usually fails to respond to conventional transurethral destructive surgical procedures. Collectively, our experience and the literature suggest that intravesical DMSO can be a bladder saving measure and help resolve ureterovesical obstruction in some patients. High recurrence rate mandates lifelong cystoscopic surveillance.",
keywords = "Amyloidosis, Bladder, Dimethyl sulfoxide",
author = "Malek, {Reza S.} and Wahner-Roedler, {Dietlind L.} and Morie Gertz and Kyle, {Robert A.}",
year = "2002",
month = "9",
language = "English (US)",
volume = "168",
pages = "1018--1020",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Primary localized amyloidosis of the bladder

T2 - Experience with dimethyl sulfoxide therapy

AU - Malek, Reza S.

AU - Wahner-Roedler, Dietlind L.

AU - Gertz, Morie

AU - Kyle, Robert A.

PY - 2002/9

Y1 - 2002/9

N2 - Purpose: We present our long-term experience with intravesical dimethyl sulfoxide (DMSO) for primary localized amyloidosis of the bladder. Materials and Methods: The study included 4 males and 2 females 28 to 68 years old (mean age 54) at diagnosis of biopsy proven primary localized amyloidosis involving the bladder diffusely or extensively in 1 locale. All patients had normal upper urinary tracts. They continued to be symptomatic (hematuria in 3, irritative voiding symptoms in 1, and hematuria and irritative voiding symptoms in 2) despite conventional transurethral destructive therapy. Every 2 weeks they received 30-minute instillations of 50 ml. 50% DMSO intravesically for 3 months (patient 1), 6 months (1) and 1 year (4). Results: Therapy failed at 3 and 6 months in 2 patients of whom 1 with a contracted bladder underwent cystectomy and another was stabilized for 1 year with laser therapy. In the remaining 4 patients who were followed for 6 years disease stabilized for 2 to 6 years (mean 3.5) but 3 later required additional therapy including repeat DMSO in 1 and laser therapy in 2. Conclusions: Diffuse or locally extensive bladder involvement by primary localized amyloidosis usually fails to respond to conventional transurethral destructive surgical procedures. Collectively, our experience and the literature suggest that intravesical DMSO can be a bladder saving measure and help resolve ureterovesical obstruction in some patients. High recurrence rate mandates lifelong cystoscopic surveillance.

AB - Purpose: We present our long-term experience with intravesical dimethyl sulfoxide (DMSO) for primary localized amyloidosis of the bladder. Materials and Methods: The study included 4 males and 2 females 28 to 68 years old (mean age 54) at diagnosis of biopsy proven primary localized amyloidosis involving the bladder diffusely or extensively in 1 locale. All patients had normal upper urinary tracts. They continued to be symptomatic (hematuria in 3, irritative voiding symptoms in 1, and hematuria and irritative voiding symptoms in 2) despite conventional transurethral destructive therapy. Every 2 weeks they received 30-minute instillations of 50 ml. 50% DMSO intravesically for 3 months (patient 1), 6 months (1) and 1 year (4). Results: Therapy failed at 3 and 6 months in 2 patients of whom 1 with a contracted bladder underwent cystectomy and another was stabilized for 1 year with laser therapy. In the remaining 4 patients who were followed for 6 years disease stabilized for 2 to 6 years (mean 3.5) but 3 later required additional therapy including repeat DMSO in 1 and laser therapy in 2. Conclusions: Diffuse or locally extensive bladder involvement by primary localized amyloidosis usually fails to respond to conventional transurethral destructive surgical procedures. Collectively, our experience and the literature suggest that intravesical DMSO can be a bladder saving measure and help resolve ureterovesical obstruction in some patients. High recurrence rate mandates lifelong cystoscopic surveillance.

KW - Amyloidosis

KW - Bladder

KW - Dimethyl sulfoxide

UR - http://www.scopus.com/inward/record.url?scp=0036716746&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036716746&partnerID=8YFLogxK

M3 - Article

C2 - 12187212

AN - SCOPUS:0036716746

VL - 168

SP - 1018

EP - 1020

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 3

ER -