It is advocated that patients with high-risk non-muscle-invasive bladder cancer (NMIBC) receive an adjuvant course of intravesical Bacille Calmette-Guerin ( BCG) as first-line treatment. This suggests that intravesical BCG without intradermal BCG can be an important adjunct to the conventional therapy of bladder tumors.Ĭontemporary management of patients with high-risk non-muscle-invasive bladder cancer who fail intravesical BCG therapy. In comparing those patients with superficial papillary cancer, we found a response of 39 per cent after conventional therapy and 63 per cent after conventional therapy and intravesical BCG. In those patients with carcinoma in situ of the bladder who were treated with conventional therapy (resection and/or fulguration) and intravesical bacillus Calmette-Guerin ( BCG) without intradermal BCG, and those patients who were treated with conventional therapy alone, we found a response rate of 60 per cent versus 40 per cent at the end of three months. This is a review of 100 patients at our institution who were treated for superficial bladder cancer.
Mydlo, J H Usher, S M Camacho, F Freed, S Retrospective study of efficacy of intravesical BCG alone in treatment of superficial bladder cancer. This case highlights the potential adverse reactions associated with intravesical BCG therapy that may occur years after bladder cancer therapy is completed, and should heighten physician awareness for BCG-related infections during pre-transplant assessment and post-transplant care of solid organ transplants recipients. He died from disseminated BCG-induced sepsis and failure of his renal allograft. Two years post-transplant, he developed BCG-induced sepsis confirmed by cultures from urine, blood and left native kidney biopsy. The patient subsequently received a deceased donor kidney transplant 5 years after BCG therapy, with thymoglobulin induction therapy and standard triple maintenance immunosuppression. We report a rare case in which a patient with end-stage renal disease secondary to chronic granulomatous interstitial nephritis underwent remote, pre-transplant intravesical BCG treatment for high-grade non-invasive papillary bladder carcinoma. A rare and potentially fatal complication of intravesical BCG therapy is BCG-induced sepsis. Intravesical Bacillus Camlette-Guérin ( BCG) is the treatment of choice for non-muscle invasive bladder cancer, and has been used successfully for over 40 years. Ziegler, Jennifer Ho, Julie Gibson, Ian W Nayak, Jasmir G Stein, Markus Walkty, Andrew Orr, Pamela Diagnosis is based upon history and histological examination.ĭisseminated Mycobacterium bovis infection post-kidney transplant following remote intravesical BCG therapy for bladder cancer. In most cases, an infiltrated erythematosus plaque is seen together with yellowish papules in certain patients. There is no stereotypical clinical presentation. Since then, there have been nine other reports. The first reported case of BCG infection of the glans in patients undergoing intravesical BCG therapy was published in 1992. Triple antitubercular antibiotic therapy was initiated. Histology revealed granulomatous dermal lesions with eosinophilic necrosis. Antibiotic treatment comprising ofloxacin followed by rifampicin for two months proved ineffective. One week later, papular nodules appeared on the glans with a sclerosing lesion of the balanopreputial sac, dark purple perimeatal papules and a mass beneath the mucosa of the glans. Case 2: In a 61-year-old man receiving BCG therapy for relapsing bladder carcinoma in situ, the sixth instillation was considered traumatic since it was highly painful. Slow cure of the lesions was achieved within 12months using double antitubercular antibiotic therapy. Histology revealed epithelioid giant-cell granulomas. Three months later, examination revealed massive painful perimeatal ulceration with yellowish papules in the peripheral regions. One week after the seventh instillation, severe balanitis developed. Case 1: A 77-year-old man presented relapsing urothelial bladder carcinoma treated by endoscopic resection and BCG therapy. BCG infection of the glans is a rare local complication associated with this treatment, two cases of which are reported below.
Therapy involves intravesical instillation of live attenuated Calmette-Guérin bacilli. Michelet, N Spenatto, N Viraben, R Cuny, J-F Mazet, J Trechot, P Barbaud, A Schmutz, J-LīCG therapy is an effective adjuvant treatment for superficial bladder tumors.
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