A critical review of the management of bladder neoplasia using a modified form of Helmstein's pressure therapy.

30 patients with proven bladder malignant disease have been treated by Helmstein's hydrostatic pressure technique. Massive necrosis of tumour tissue has been shown to occur at cystoscopy, cytologically and on histological examination. Double contrast cystography can indicate reduction in tumour size within 2 weeks of treatment Haematuria is usually stopped with diminution of frequency and dysuria. This treatment is suitable for large bulky T1 tumours and advanced T4 growths where palliation is the only treatment possible but not for TI and T3 growths. Elderly and ill patients can tolerate this therapy easily and there were no serious side-effects in this series.