HNY Policy and Pathway Repository - North Lincolnshire

Non-muscle invasive bladder cancer

This intervention is only commissioned when used in accordance with the recommendations specified in the Academy of Medical Royal Colleges (AoMRC) Evidence Based Interventions (EBI) programme: Transurethral resection of bladder tumour (TURBT) single post instillation of mitomycin C (SPI-MMC) - EBI

The EBI panel reviewed guidelines on MMC delivery after TURBT, noting the EUA's recommendation for administration within the first few hours versus the 24-hour window used in clinical trials. Feedback from GIRFT site visits highlighted that not giving MMC in theatre or recovery often led to missed doses, delayed discharge, and unnecessary overnight stays. Units with optimal practices overcame barriers to administering MMC promptly. Considering both clinical and operational evidence, the panel recommended delivering MMC in theatre or recovery, or otherwise within 6 hours post-TURBT. Evidence also supports cost-effectiveness when MMC is given immediately rather than delayed, with additional savings possible by increasing day case rates and improving patient experience. Overall, the EBI panel supported administering MMC as soon as possible after TURBT.

Transurethral resection of bladder tumour (TURBT) single post instillation of mitomycin C (SPI-MMC) - EBI