title: Bacillus Calmette-Guérin perfusion therapy for carcinoma in situ of the upper urinary tract.
abstract: OBJECTIVE
  To analyse the clinical and therapeutic consequences of bacillus Calmette-Guérin (BCG) perfusion therapy for carcinoma in situ (CIS) of the upper urinary tract.
  
  
  METHODS
  Eight pyelo-ureteric systems in five patients with cytologically confirmed CIS of the upper urinary tract were treated using perfusion of BCG through a percutaneous nephrostomy tube in five and a retrograde ureteric catheter in three. Follow-up cystoscopy, retrograde pyelography and selective urinary cytology were obtained 4 weeks after the last treatment and every 3 months thereafter.
  
  
  RESULTS
  In three patients (five pyelo-ureteric systems) the cytology remained negative for 10-46 months after the treatment was completed. The remaining two patients (three pyelo-ureteric systems) had persistently positive cytology. Of two patients who received BCG therapy through a ureteric catheter, one developed a ureteric stricture and the other developed renal tuberculosis.
  
  
  CONCLUSIONS
  Although long-term adaptation to a nephrostomy tube disturbs the quality of life of the patient, percutaneous perfusion therapy through a nephrostomy tube seems to be safer than retrograde perfusion through a ureteric catheter.
authors.affiliation: Department of Urology, Shimane Medical University, Izumo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yokogi
authors.forename: Y
authors.initials: Y
authors.lastname: Wada
authors.forename: M
authors.initials: M
authors.lastname: Mizutani
authors.forename: M
authors.initials: M
authors.lastname: Igawa
authors.forename: T
authors.initials: T
authors.lastname: Ishibe
mesh_terms: D000368:Aged; D001500:BCG Vaccine / Q000627:therapeutic use*; D002278:Carcinoma in Situ / Q000628:therapy*; D010478:Chemotherapy, Cancer, Regional Perfusion; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014516:Ureteral Neoplasms / Q000628:therapy*; D001749:Urinary Bladder Neoplasms / Q000628:therapy; D014546:Urinary Catheterization
chemical_list: D001500:BCG Vaccine