title: [The diagnosis and treatment for carcinoma in situ of the bilateral upper urinary tracts after total cystectomy and ileal conduit by intentionally inducing hydronephrosis].
abstract: We report the diagnosis and treatment for carcinoma in situ of the bilateral upper urinary tracts after total cystectomy and ileal conduit by intentionally inducing hydronephrosis. A 75-year-old man whose chief complaints were macroscopic hematuria and bladder irritabilities was diagnosed carcinoma in situ of the bladder and underwent total cystectomy and ileal conduit. 26 months after the operation, the cytological examination of ileal conduit urine revealed urothelial carcinoma. Since the radiographic findings in the upper urinary tracts and ileal conduit were negative, we constructed bilateral percutaneous nephrostomies by intentionally inducing hydronephrosis. Since two serial cytological examinations of the urine sampling from the bilateral pyeloureteral systems revealed urothelial carcinoma, we performed the percutaneous Bacillus Calmatte-Guerin perfusion of the bilateral upper urinary tracts. The therapy was repeated at weekly intervals for a total of 11 perfusions and the cytological examination of ileal conduit urine became negative 4 months after the beginning of the therapy. Intentionally induced hydronephrosis is useful for the diagnosis and treatment for carcinoma in situ of the bilateral upper urinary tracts after total cystectomy and ileal conduit.
authors.affiliation: Department of Urology, Osaka General Medical Center.
authors.forename: Jun
authors.initials: J
authors.lastname: Saito
authors.forename: Taigo
authors.initials: T
authors.lastname: Kato
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kakuta
authors.forename: Masato
authors.initials: M
authors.lastname: Tanaka
authors.forename: Koji
authors.initials: K
authors.lastname: Yazawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hosomi
authors.forename: Kiichiro
authors.initials: K
authors.lastname: Ito
mesh_terms: D000368:Aged; D001500:BCG Vaccine / Q000008:administration & dosage*; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000628:therapy; D015653:Cystectomy; D006801:Humans; D006869:Hydronephrosis; D008297:Male; D009378:Neoplasms, Multiple Primary; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014547:Urinary Diversion; D014571:Urologic Neoplasms / Q000175:diagnosis* / Q000628:therapy; D013520:Urologic Surgical Procedures / Q000379:methods
chemical_list: D001500:BCG Vaccine