title: BCG Induced Necrosis of the Entire Bladder Urothelium.
abstract: Instillation therapy with attenuated tuberculosis bacteria (BCG) can significantly reduce rates of recurrence of non-muscle invasive bladder cancer. Local and systemic side effects such as dysuria, irritative voiding symptoms or partial bladder contracture and systemic inflammation were reported. A 75 year-old male patient with recurrent non muscle invasive bladder cancer developed necrosis of the entire bladder urothelium more than six years after BCG instillation immunotherapy. The resulting irritative voiding symptoms and low bladder capacity required radical cystectomy. BCG instillation can cause severe side effects, which develop gradually and eventually need radical surgical therapy such as cystectomy without tumor recurrence.
authors.affiliation: Medical Centre, University of Freiburg, Department of Urology, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany.
authors.forename: Malte
authors.initials: M
authors.lastname: Krönig
authors.affiliation: Medical Centre, University of Freiburg, Department of Urology, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany.
authors.forename: Cordula
authors.initials: C
authors.lastname: Jilg
authors.affiliation: Medical Centre, University of Freiburg, Department of Radiology, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Burger
authors.affiliation: Medical Centre, University of Freiburg, Department of Radiology, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany.
authors.forename: Mathias
authors.initials: M
authors.lastname: Langer
authors.affiliation: Medical Centre, University of Freiburg, Department of Pathology, Breisacher Strasse 155a, 79106 Freiburg im Breisgau, Germany.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Timme-Bronsert
authors.affiliation: Medical Centre, University of Freiburg, Department of Pathology, Breisacher Strasse 155a, 79106 Freiburg im Breisgau, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Werner
authors.affiliation: Medical Centre, University of Freiburg, Department of Urology, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wetterauer
authors.affiliation: Medical Centre, University of Freiburg, Department of Urology, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany.
authors.forename: Wolfgang-Schultze
authors.initials: WS
authors.lastname: Seemann
keywords: BCG; BCG, Bacille Calmette Guerin; Bladder cancer; Cystectomy; MIBC, muscle invasive bladder cancer; NMIBC, non muscle invasive bladder cancer; Urothelial necrosis