Microbladder due to Granulomatous Cystitis Secondary to BCG Treatment
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María Medina-González [1] ; Jorge Panach-Navarrete [1] ; Daniel Mata-Cano [1] ; José María Martínez Jabaloyas [1]
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[1] Hospital Clinico Universitario de Valencia
Hospital Clinico Universitario de Valencia
Valencia, España
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- Localización: Archivos españoles de urología, ISSN 0004-0614, Tomo 75, Nº. 8, 2022, págs. 729-730
- Idioma: español
- Texto completo no disponible (Saber más ...)
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Resumen
Introduction: Intravesical immunotherapy with bacillus Calmette-Guerin (BCG) is considered as the standard treatment for non-muscle invasive bladder cancer with high risk of recurrence and progression.
Objective: To report a case of granulomatous cystitis in a patient receiving BCG intravesical therapy for urothelial carcinoma.
Material and Methods: A 63-year-old man underwent BCG treatment for a bladder tumor with pathological diagnosis of T1G3 urothelial carcinoma. Five months later, trans urethral resection (TUR) of bladder was performed for an erythematous lesion, with results of post-BCG cystitis. Two years later, the patient presented with hematuria and with suspicious findings in the cystoscopy (extensive fibrin-covered and calcified lesions in the bladder) and a bladder TUR was done.
Results: The histopathological study showed granulomatous cystitis with necrosis and the presence of BAAR compatible with post-BCG origin. In the mycobacterial culture, M. bovis grew, and treatment was initiated. A cystography was performed on suspicion of a microbladder on CT with secondary vesicoureteral reflux, confirmed in this test. It was decided to perform a radical cystectomy. Histopathology reported post-BCG granulomatous cystitis and prostatitis.
Conclusions: After BCG treatment, if symptoms or images are suggestive of granulomatous cystitis, a study of mycobacterial infection should be started to avoid the development of complications, such as the microbladder as in the case we present.
