| BACKGROUND:Bladder cancer is one of the most common malignant tumors in the urinary system,in which non muscular-invasive bladder cancer accounted for 75%-85%.The guidelines indicate that it is effective to prevent tumor recurrence and tumor leaching development for patients with non-muscular immersion bladder cancer who have been electrocuted by the urethra bladder tumor,supplemented by intravesical instillation chemicals or biological agents.Some patients appeared urinary infection and hypothermia irritation symptoms during the postoperative continuous intravesical instillation treatment process,which has brought a series of problems to the clinician’s treatment work.However,there are few studies on urinary infection status,lower urinary tract irritation symptoms and tolerance among patients undergoing postoperative intravesical instillation therapy.To investigate the change of pyuria and urinary tract stimulation symptoms in patients with NMIBC and the multiple factors affecting pyuria urine condition in the course of intravesical instillation therapy after TURBT among Patients with NMIBC.METHODS:Follow-up was carried out in patients diagnosed with NMIBC in June 2017-November 2019 in urology surgery at Tianjin Medical University Second Hospital.These patients need to undergo postoperative intravesical instillation therapy once a week,which lasts 8 weeks in the first stage.Patients included in the study were required to undergo a routine urine test every week and fill out a core urinary tract symptom gauge.If the patient’s urinary white blood cells are over 50/HPF,a urine culture test is required.During the follow-up period,the patient’s pyuria rate,severe pyuria rate,bacteria urine rate and CLSS score were recorded before each intravesical treatment,so as to observe the change trend of pyuria and lower urinary tract symptom score and investigate factors affecting the patient’s postoperative pyuria in combination with clinical data.RESULTS:Pearson correlation analysis of postoperative urinary white blood cells and CLSS in NMIBC patients suggested that the core lower urinary tract symptom score was significantly correlated with urinary white blood cells.but there is no significant correlation between the performance of lower urinary tract symptoms in female patients and the level of urinary white blood cells.In the study on the effect of blood glucose on pyuria,it was found that the urine white cells of diabetic patients was significantly higher than that of non-diabetic patients.Patients with Begin ProtasticsHyperplasia(BPH)are more likely to have severe pyuria in postoperative intravesical therapy.Tumour size is positively correlated with postoperative urinary white blood cells.Patients with preoperative pyuria have a high probability of pyuria after surgery.In addition,people with high pathological grading are more likely to suffer serve postoperative pyuria,while age is also a factor affecting postoperative pyuria condition.CONCLUSIONS:The increase of urinary white blood cells is very common among postoperative NMIBC patients,but the presence of pyuria can not indicate the existence of a clear urinary tract infection.Pyuria and CLSS are gradually declining over time.Urinary white blood cells and core lower urinary tract symptom score of postoperative are correlated,while the study targeted at female group founds that there is no significant correlation between pyuria and CLSS.The postoperative pyuria of patients is influenced by many factors,including BPH,ages,diabetes,tumour siz,preoperative pyuria,pathological grading and so on.Therefore,the level of urinary white blood cells should not be a clinical index to evaluate the urinary tract infection of postoperative NMIBC patients.Urology clinicians may need to combine pyuria condition,LUTS symptoms and the patient’s own condition to take to a comprehensive consideration.Exploring a reasonable scientific multi-dimensional evaluation system may provide some reference value for the clinical work of urologists. |
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