Gerharz E W, Weingärtner K, Melekos M D, Varga S, Feiber H, Riedmiller H
Department of Urology, Philipps-University Medical School, Marburg, Germany.
Br J Urol. 1995 Oct;76(4):479-81. doi: 10.1111/j.1464-410x.1995.tb07750.x.
To report a serious side-effect of intravesical instillations of neomycin in patients with end-stage renal disease.
Three patients (two men and a woman, aged 51.71 and 54 respectively) with end-stage renal disease who had undergone bladder irrigation with neomycin sulphate solution suffered complete irreversible deafness, which was assessed by audiogram.
All three patients developed complete perception deafness after 3, 4 and 10 months, with characteristic changes in the audiogram. The severe progressive hearing loss was maximal in the high-frequency range. A high-pitched tinnitus was the first sign of impending hearing difficulty and two patients developed a spontaneous nystagmus.
In view of the doubtful efficacy and, most importantly, the risk of severe disabling side-effects such as ototoxicity, we recommend the avoidance of intravesical instillation with neomycin whenever possible.
报告终末期肾病患者膀胱内灌注新霉素的一种严重副作用。
三名终末期肾病患者（两名男性和一名女性，年龄分别为51、71和54岁）接受了硫酸新霉素溶液膀胱冲洗，经听力图评估出现了完全不可逆的耳聋。
所有三名患者在3、4和10个月后均出现完全感音性耳聋，听力图有特征性变化。严重的进行性听力损失在高频范围内最为明显。高调耳鸣是即将出现听力困难的首个迹象，两名患者出现了自发性眼球震颤。
鉴于疗效存疑，且最重要的是存在耳毒性等严重致残副作用的风险，我们建议尽可能避免膀胱内灌注新霉素。
