NEOMYCIN-INDUCED PERCEPTION DEAFNESS FOLLOWING BLADDER IRRIGATION IN PATIENTS WITH END-STAGE RENAL-DISEASE

Objective To report a serious side-effect of intravesical instillation s of neomycin in patients with end-stage renal disease. Patients and m ethods Three patients (two men and a woman, aged 51,71 and 54 respecti vely) with endstage renal disease who had undergone bladder irrigation with neomycin sulphate solution suffered complete irreversible deafne ss, which was assessed by audiogram. Results All three patients develo ped complete perception deafness after 3, 4 and 10 months, with charac teristic 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 develo ped a spontaneous nystagmus. Conclusion In view of the doubtful effica cy and, most importantly, the risk of severe disabling side-effects su ch as ototoxicity, we recommend the avoidance of intravesical instilla tion with neomycin whenever possible.