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Microbladder due to Granulomatous Cystitis Secondary to BCG Treatment
María Medina-González1, Jorge Panach-Navarrete1, Daniel Mata-Cano2
1Departamento de Urología, Hospital Clínico Universitario de Valencia, Facultat de Medicina i Odontologia, Universitat de València, Valencia, España.
Archivos Espanoles De Urologia
|November 4, 2022
Summary
Bacillus Calmette-Guerin (BCG) therapy for bladder cancer can cause granulomatous cystitis. Early diagnosis of this complication is crucial to prevent severe outcomes like microbladder formation.
Area of Science:
- Urology
- Oncology
- Infectious Diseases
Background:
- Intravesical bacillus Calmette-Guerin (BCG) is a standard treatment for high-risk non-muscle invasive bladder cancer.
- BCG immunotherapy effectively reduces recurrence and progression rates.
Observation:
- A 63-year-old male with urothelial carcinoma received intravesical BCG therapy.
- He developed post-BCG cystitis and later presented with hematuria and suspicious bladder lesions.
- Further investigations revealed granulomatous cystitis with M. bovis infection and microbladder with vesicoureteral reflux.
Findings:
- Histopathology confirmed granulomatous cystitis and prostatitis, with acid-fast bacilli (BAAR) consistent with BCG origin.
- Mycobacterial culture identified Mycobacterium bovis.
- Imaging demonstrated a contracted bladder (microbladder) and secondary vesicoureteral reflux.
Implications:
- Prompt investigation for mycobacterial infection is essential when granulomatous cystitis is suspected after BCG treatment.
- Early diagnosis and management can prevent severe complications such as microbladder and vesicoureteral reflux.
- This case highlights the importance of vigilant monitoring for BCG-related complications in bladder cancer patients.
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