Sawada Tatsuhiro, Igarashi Ayaka, Arai Seiji, Ohtsu Akira, Fujizuka Yuji, Nakazawa Shun, Sekine Yoshitaka, Koike Hidekazu, Furuya Yosuke, Suzuki Kazuhiro
Department of Urology Gunma University Hospital Maebashi Gunma Japan.
Department of Urology Kurosawa Hospital Takasaki Gunma Japan.
IJU Case Rep. 2024 Nov 22;8(1):69-72. doi: 10.1002/iju5.12814. eCollection 2025 Jan.
Intravesical Bacillus Calmette-Guérin immunotherapy is generally a safe treatment for non-muscle-invasive bladder cancer but sometimes causes complications.
The patient was an 80-year-old man who had undergone Bacillus Calmette-Guérin immunotherapy for non-muscle-invasive bladder cancer. Two months later, he developed an irregular pelvic mass surrounding the prostate and rectum with no fever. A colonoscopy showed purulent mucus discharge in the lower rectum, and a CT-guided needle biopsy revealed epithelioid granuloma containing Langhans giant cells. Although acid-fast bacteria culture and PCR of biopsy samples were negative, he was clinically diagnosed with Bacillus Calmette-Guérin-related tuberculous prostatic abscess spreading to the rectum. After receiving combined antitubercular drugs for 6 months, his discomfort disappeared with almost complete shrinkage of the prostatic abscess.
Tuberculous prostatic abscess is a rare complication associated with Bacillus Calmette-Guérin immunotherapy and sometimes induces rectal fistula. Conservative treatment with antitubercular drugs is efficient and safe for treatment of tuberculous prostatic abscess.
膀胱内卡介苗免疫疗法通常是治疗非肌层浸润性膀胱癌的一种安全治疗方法，但有时会引起并发症。
该患者为一名80岁男性，曾接受卡介苗免疫疗法治疗非肌层浸润性膀胱癌。两个月后，他出现了围绕前列腺和直肠的不规则盆腔肿块，无发热。结肠镜检查显示直肠下段有脓性黏液分泌物，CT引导下穿刺活检显示含有朗汉斯巨细胞的上皮样肉芽肿。尽管活检样本的抗酸杆菌培养和聚合酶链反应均为阴性，但他临床诊断为卡介苗相关的结核性前列腺脓肿蔓延至直肠。接受联合抗结核药物治疗6个月后，他的不适消失，前列腺脓肿几乎完全缩小。
结核性前列腺脓肿是卡介苗免疫疗法相关的一种罕见并发症，有时会导致直肠瘘。抗结核药物的保守治疗对结核性前列腺脓肿的治疗有效且安全。
