Intravesical instillation of bacille Calmette-Guérin for carcinoma in situ of the urothelium involving the upper urinary tract using vesicoureteral reflux created by a double-pigtail catheter.

Abstract

OBJECTIVES:

To evaluate the therapeutic efficacy of bacille Calmette-Guérin (BCG) for carcinoma in situ (CIS) of the urothelium involving the upper urinary tract when the vaccine was administered by way of the bladder using vesicoureteral reflux created by a double-pigtail (DP) catheter.

METHODS:

Thirteen upper urinary tracts of 9 patients with cytologically diagnosed CIS, with concomitant bladder CIS in 4, were treated by intravesical BCG instillation. A DP catheter was placed retrogradely, and the appearance of vesicoureteral reflux was confirmed by cystography. BCG (1 to 2 mg/mL) in a volume sufficient to fill the renal caliceal system was administered into the bladder weekly for 6 weeks. The mean follow-up was 36 months (range 8 to 97).

RESULTS:

The voided urine cytology turned negative in all 9 patients at a mean of 86 days after the first administration of BCG. The voided urine cytology returned positive afterward in 3 patients, and positive cytology in the upper urinary tract was confirmed in 1 of 13 treated urinary tracts, which were successfully treated by another course of BCG therapy with the DP catheter. Minor adverse effects related to BCG and the DP catheter were seen in 5 patients.

CONCLUSIONS:

BCG therapy for the CIS involving the upper urinary tract using a DP catheter might have the potential to be an effective procedure preserving renal units and could be adopted not only as an imperative, but also as an elective, treatment option.

• Authors: Akira Irie, Masatsugu Iwamura, Kazuomi Kadowaki, Asako Ohkawa, Toyoaki Uchida, Shiro Baba
• Journal: Urology (Urology) Vol. 59 Issue 1 Pg. 53-7 (Jan 2002) ISSN: 1527-9995 [Electronic] United States
• PMID: 11796281 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• BCG Vaccine

Topics

• Administration, Intravesical
• BCG Vaccine (administration & dosage)
• Carcinoma in Situ (pathology, therapy)
• Humans
• Ureteral Neoplasms (pathology, therapy)
• Urinary Bladder Neoplasms (pathology, therapy)
• Urine (cytology)