Novel Use of Intravesical Bromelain and N-acetylcysteine for Pseudomyxoma Peritonei with Bladder Involvement: Case Series

Introduction: Pseudomyxoma peritonei (PMP) is a rare and challenging neoplastic condition associated with great morbidity when left untreated. The standard treatment is cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC). However, not all patients are suitable candidates for extensive operative management, necessitating alternative avenues to symptom management. Bromac is a combination of bromelain and N-acetylcysteine which demonstrates mucolytic effects and has been shown to alleviate the compressive effects of PMP.