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Reviews
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What are the main claims of the paper and how important are they?
The article reports on use of formalin intravesically for intractable hemorrhagic cystitis.
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Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.
It is novel to use this ancient treatment method at present time.
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Are the claims properly placed in the context of the previous literature?
No - some literature is listed at the end of article - but not referenced in the text!
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Do the results support the claims? If not, what other evidence is required?
Yes, it seems authors results support their claims, but much more elaborated results would be necessary.
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If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?
Protocol of treatment is described in detail enough to grasp the idea and actually the protocol - method itself is the main objective of this work, however, further details would be necessary (for example 5% formalin - which gives which final concentration of formaldehyde; was biopsy performed before or during the same session...).
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Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?
Methodology in an retrograde audit trial is obvious and plane.
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Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?
Additional information - a quite lot of it - would be necessary to make this otherwise very interesting submission - extended abstract - a publishable paper.
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Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?
This extended abstract reports on use of treatment most of us do not dare to use due to safety concerns. It shows a particular method described to obviate some concerns and makes most risks managable (instillation during anesthesia for a particular limited time, particular drug concentration). With proper discussion, references in the text and more detailed explanation of methods and results, making this submission a proper article, this would most probably get citations in the urologic literature.
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Other Comments:
Almost forgotten technique, reported here, is still valid for very selected cases. Further details would be attractive for readers (protocol of heamostatic attempt befere this treatment - which agents do authors use, in which dosages...). Median 15 months post radiotherapy - relatively early haemorrhagic cystitis complications. What doses of radiation were used, which techniques...
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Competing interests:
None.
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Invited by the author to review this article? :
No -
Have you previously published on this or a similar topic?:
No
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References:
None -
Experience and credentials in the specific area of science:
I also care for patients with similar problems, but was until now afraid to use this particular technique due to safety reasons.
- How to cite: Hajdinjak T .Re: The Use of Intravesical Formalin for Hemorrhagic Cystitis[Review of the article 'The Use of Intravesical Formalin for Hemorrhagic cystitis : Our Experience ' by Hicham E].WebmedCentral 2012;3(6):WMCRW001904
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intravesical formaline is an ideal treatment for hemorrhagic cystitis.
the claim is totally wrong and should not be applied unless all other ways have been already tried.
No, the claim is very old studied for decades and already proved that intravesical formaline has fatal complications and considerable morbidities.
intravesical formaline should be used only in cases of intractable hematuria that doesn't respond to other modalities.
intravesical alum or silver nitrate had to be tried first.
1% formaline is associated with lower morbidity if needed, not 5% as used in the reported cases.
i don't believe they are all followed with no complicatons, i believe 5% intravesical formaline instillation following pelvic radiotherapy would result in functional bladder loss.
No, the authors are discussing very old claim as if that is novel finding. no single previous literature was cited in the supposed to be review.
when demonstraing results of 5 cases, you can nominate them case reports, but not experience.
their result support their claim.
i would like to see any radiological images showing the bladder of those patients, done during the follow up, post intravesical formaline.
authors are just explaining their belief, they didn't do any studies compared to literatures.
authors didn't mention radiation dose and plan
they didn't mention if they did VCUG to their patients prior to managment, as intravesical formaline is absolutely contraindicated in presence of reflux and VCUG is a must do investigation for these patients.
i would prefer doing honnest review of literatures.
i would appreciate describing institutional shortage made them only have to start with intravesical formaline, instead of other agents.
i would like to see radiological investigations included in their work
no that work has to be obsolete except in very selected cases
good luck in other work
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i am uro-oncology surgeon, i get confronted with some of these cases during my work