Histopathological effects of intravesical boric acid in a rat model of non–muscle-invasive bladder cancer

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To evaluate the histopathological effects of intravesical boric acid administration in a rat model of bladder cancer induced by intravesical N-methyl-N-nitrosourea. Thirty female Wistar albino rats (200–240 g) were included in the study. Bladder carcinogenesis was induced in all animals by intravesical administration of N-methyl-N-nitrosourea. The rats were randomly assigned to five groups ( n = 6 per group) before initiation of the experimental protocol. All animals subsequently underwent intravesical N-methyl-N-nitrosourea administration to induce bladder carcinogenesis: untreated tumor group, saline-treated group, and three experimental groups receiving intravesical boric acid at doses of 65, 100, and 154 mg/kg for six weeks. Nine animals were lost during the experimental period; therefore, the final histopathological analyses were performed on 21 animals. The primary outcome was the normal urothelial area score based on the estimated proportion of normal urothelial areas on histopathological evaluation. Secondary outcomes included hyperplasia severity score and carcinoma in situ severity score. A statistically significant difference was observed among the groups in terms of the normal urothelial area score ( p = 0.002). Post hoc analysis revealed that the boric acid 100 mg/kg and boric acid 154 mg/kg groups had significantly higher normal urothelial area scores compared to the boric acid 65 mg/kg group ( p = 0.014 and p = 0.043, respectively). Although higher normal urothelial area scores were also observed in the higher-dose boric acid groups compared to the untreated tumor and saline-treated groups, these differences did not reach statistical significance. No statistically significant differences were found among the groups in terms of hyperplasia severity score ( p = 0.343) or CIS severity score ( p = 0.077). Intravesical boric acid administration was associated with a significant increase in the normal urothelial area score, suggesting a potential protective or regenerative effect on the urothelium rather than a direct antitumor effect. These findings should not be interpreted as evidence of antitumor efficacy. Further studies are required to clarify the underlying mechanisms and to determine the potential clinical relevance of these findings in non–muscle-invasive bladder cancer.

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