A comparative study of intravesical instillation of 15(s) 15 Me alpha and alum in the management of persistent hematuria of vesical origin.

A prospective randomized, controlled study was done to compare the efficacy and safety of 15(s) 15 Me PGF2 alpha intravesical instillation and 1% alum vesical irrigation in the control of vesical hematuria which persisted even after continuous bladder irrigation with normal saline for 24 hours. Ten patients were treated with 15(s) 15 Me PGF2 alpha intravesical instillation in a dose of 1 mg daily for a maximum of 5 days. Six patients had complete cessation of macroscopic hematuria and partial control was seen in another 2 patients. Failure of control was seen in 2 patients. Nine patients were treated with 1% alum irrigation of bladder at a rate of 5 ml/min for a maximum period of 72 hours. Complete cessation of hematuria occurred in 6 patients and partial control in the other 3 patients. Bladder spasms was a common side effect of both drugs (19/19). Frequent catheter blockade (7/9) and recurrence of bleeding (3/9) were also seen with alum therapy. No systemic side effects occurred during therapy with both drugs. Alum, due to its safety and efficacy remains the drug of first choice for persistent vesical hematuria. High cost, low availability and stringent storage conditions are drawbacks for routine use of 15(s) 15 Me PGF2 alpha, however, PGF2 alpha promises to be a safe and effective alternative method and might be of great value in cases of alum failure as observed in two of our cases (9 and 10).