Kimura Kyosuke, Matsuura Osamu, Isobe Yasuaki, Kamihira Osamu, Kondo Atsuo
Department of Urology, Komaki Shimin Hospital.
Nihon Hinyokika Gakkai Zasshi. 2003 Jul;94(5):574-7. doi: 10.5980/jpnjurol1989.94.574.
We report a patient whose irritable bladder symptoms following Bacillus Calmette Guerin (BCG) instillation were satisfactorily treated by steroid administration. A 59-year-old male had undergone transurethral resection for the bladder carcinoma recurred three times. The histopathological examination revealed the tumor as transitional cell carcinoma, G1 to G2, and pTa. Subsequently an instillation of 80 mg BCG into the bladder was planned 8 times every 7 days. After the 5th instillation he presented with gross hematuria, painful micturition, pollakisuria, urgency and reduced bladder capacity of 15 ml. The dose was reduced to 40 mg and another 3 instillations were accomplished. Since conventional treatments of anti-cholinergics, analgesics and epidural anesthesia were of little help for the subjective symptoms, he was put on the steroid pulse therapy 2 weeks after completion of the BCG regimen. The treatment gradually improved the subjective symptoms and increased the bladder capacity up to 160 ml. In conclusion, we believe that the steroid pulse therapy deserves considering in the early stage of irritable bladder symptoms following BCG instillation.
我们报告了一例卡介苗（BCG）膀胱灌注后出现膀胱激惹症状的患者，通过给予类固醇治疗，症状得到了满意缓解。一名59岁男性因膀胱癌复发接受了3次经尿道切除术。组织病理学检查显示肿瘤为移行细胞癌，G1至G2级，pTa期。随后计划每7天向膀胱内灌注80mg卡介苗，共8次。第5次灌注后，他出现肉眼血尿、排尿疼痛、尿频、尿急，膀胱容量降至15ml。剂量减至40mg，又完成了3次灌注。由于抗胆碱能药物、镇痛药和硬膜外麻醉等传统治疗对主观症状帮助不大，在完成卡介苗治疗方案2周后，他接受了类固醇脉冲疗法。治疗逐渐改善了主观症状，膀胱容量增加至160ml。总之，我们认为在卡介苗灌注后出现膀胱激惹症状的早期阶段，类固醇脉冲疗法值得考虑。
