Introduction: No established technique for locating solitary carcinoma in situ (CIS) of the urinary bladder or CIS accompanying bladder cancer has been determined. Here we investigated whether the location of CIS of the urinary bladder can be macroscopically ascertained by instilling pirarubicin hydrochloride (THP) into the urinary bladder. Patients and Methods: We dissolved 50 mg of THP in 50 ml of distilled water, and instilled the resulting solution into the urinary bladder. After 5 min, the urinary bladder is examined using a cystoscope. The study group consisted of 30 subjects (23 men and 7 women). Results: THP uptake was seen in 19 flat (nontumorous) areas of the bladder mucosa in 13 patients. Of these, 11 lesions in 6 patients were confirmed to be CIS. THP uptake was also seen in flat malignant lesions such as bladder cancer invasion into the prostatic urethra, and in benign lesions such as chronic cystitis and urothelial hyperplasia. Conclusions: The present method can be useful to find easily and macroscopically the location of flat malignant lesions such as CIS.

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