Hi Gang,
I'd heard from a European expert at a conference a few years ago that one of his patients died during a post TUR Mito instillation because there had been a perforation. After that, I'd read the warnings that nobody should instill Mitomycin if there's the slightest suspicion of a tear. I've read many times that older women post-menopause, have very thin bladders. Also people who've undergone many TURs get thinning from the procedures themselves.
I haven't heard of Mitomycin being banned from use as a post-TUR tx, though. But...in Europe the drug Epirubicin is more commonly used as an intravesical chemo, and in the US it's Mitomycin. Probably because it has the most information on use for blc, perhaps because it's cheap, and the common agreement is that all the intravescial chemos are more or less equal when it comes to efficacy.
I'm not a big fan of the new guidelines advising a dose of chemo for low risk bladder cancer, all the drugs used have potential side effects and none of them are claimed to have a benefit extending more than two years from diagnosis. In other words they only work for a short time, delaying recurrence and not stopping progression. I'm not sold. But the uro-onc field knows that cost efficiency is a huge issue and delaying a TUR can save a whole lot of money if you apply that to the millions of TURs being done each year.
Wendy