{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:51:26Z","timestamp":1777463486266,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bladder Cancer"],"published-print":{"date-parts":[[2021,5,19]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Urologic guidelines recommend perioperative instillation of chemotherapy after transurethral resection of bladder tumor (TURBT) to decrease tumor recurrence, yet implementation of this recommendation is partial due to associated morbidity. Hypertonic saline destroys cells by osmotic dehydration and might present a safer alternative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To evaluate the safety of 3% hypertonic saline (Hypersal) intravesical instillation following TURBT in rats and in humans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>In 8 rats whose bladders were electrically injured, intravesical blue-dyed Hypersal was administered. We measured serum sodium levels before and after instillation and pathologically evaluated their pelvic cavity for signs of inflammation or blue discoloration. Twenty-four patients were recruited to the human trial (NIH-NCT04147182), 15 comprised the interventional and 10 the control group (one patient crossed over). Hypersal was given postoperatively. Serum sodium was measured before, 1 hour and 12\u201324 hours after instillation. Adverse effects were documented and compared between the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>In rats, average sodium levels were 140.0\u200amEq\/L and 140.3\u200amEq\/L before and following instillation, respectively. Necropsy revealed no signs of inflammation or blue discoloration. In humans the average plasma sodium levels were 138.6\u200amEq\u2216L, 138.8\u200amEq\u2216L and 137.7\u200amEq\u2216L before, 1 hour and 12\u201324 hours after instillation, respectively. During the postoperative follow-up there was one case of fever. A month after the surgery, dysuria was reported by 5 patients while urgency and hematuria were reported by one patient each. The most severe adverse events were grade 2 on the Clavien-Dindo scale. Adverse events were similar in the control group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Hypersal instillation is safe and tolerable immediately after TURBT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3233\/blc-200328","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T14:36:50Z","timestamp":1617374210000},"page":"187-192","source":"Crossref","is-referenced-by-count":0,"title":["Single Instillation of Hypertonic Saline Immediately Following Transurethral Resection of Bladder Tumor for Recurrence Prevention \u2013A Phase I Study"],"prefix":"10.1177","volume":"7","author":[{"given":"Jonathan","family":"Modai","sequence":"first","affiliation":[{"name":"Urology Department, Kaplan Medical Center, Rehovot, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexey","family":"Kovalyonok","sequence":"additional","affiliation":[{"name":"Urology Department, Kaplan Medical Center, Rehovot, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avigdor","family":"Scherz","sequence":"additional","affiliation":[{"name":"Department of Plant and Environmental Sciences, The Biochemistry Faculty, Weizmann Institute of Science, Rehovot, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dina","family":"Preise","sequence":"additional","affiliation":[{"name":"Life Science Core Facilities, Weizmann Institute of Science, Rehovot, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuval","family":"Avda","sequence":"additional","affiliation":[{"name":"Urology Department, Kaplan Medical Center, Rehovot, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igal","family":"Shpunt","sequence":"additional","affiliation":[{"name":"Urology Department, Kaplan Medical Center, Rehovot, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keren","family":"Sasson","sequence":"additional","affiliation":[{"name":"Department of Plant and Environmental Sciences, The Biochemistry Faculty, Weizmann Institute of Science, Rehovot, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morad","family":"Jaber","sequence":"additional","affiliation":[{"name":"Urology Department, Kaplan Medical Center, Rehovot, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yamit","family":"Peretz","sequence":"additional","affiliation":[{"name":"Urology Department, Kaplan Medical Center, Rehovot, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roy","family":"Croock","sequence":"additional","affiliation":[{"name":"Urology Department, Kaplan Medical Center, Rehovot, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaniv","family":"Shilo","sequence":"additional","affiliation":[{"name":"Urology Department, Kaplan Medical Center, Rehovot, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergey","family":"Ikher","sequence":"additional","affiliation":[{"name":"Pathology Department, Kaplan Medical Center, Rehovot, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uri","family":"Lindner","sequence":"additional","affiliation":[{"name":"Urology Department, Kaplan Medical Center, Rehovot, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Leibovici","sequence":"additional","affiliation":[{"name":"Urology Department, Kaplan Medical Center, Rehovot, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,4,1]]},"reference":[{"key":"ref001","doi-asserted-by":"publisher","DOI":"10.1177\/106689690501300203"},{"key":"ref002","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)36198-0"},{"key":"ref003","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)61606-9"},{"key":"ref004","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-0143(05)70240-8"},{"key":"ref005","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000125486.92260.b2"},{"key":"ref006","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2013.0060"},{"key":"ref007","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24311"},{"key":"ref008","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2004.05.003"},{"key":"ref009","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-410x.1999.00951.x"},{"key":"ref010","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-410x.2000.00539.x"},{"key":"ref011","doi-asserted-by":"publisher","DOI":"10.1016\/S0302-2838(03)00151-9"},{"issue":"13","key":"ref012","first-page":"3317","volume":"6","author":"Shapiro 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