Zeidman E J, Helfrick B, Pollard C, Thompson I M
Urology Service, Brooke Army Medical Center, San Antonio, Texas.
Urology. 1994 Jan;43(1):121-4. doi: 10.1016/s0090-4295(94)80284-x.
To determine whether or not patients with refractory interstitial cystitis who had failed conservative therapy might benefit from intravesical bacillus Calmette-Guérin (BCG) immunotherapy.
Five patients with refractory interstitial cystitis who had failed conservative therapy underwent six weekly treatments with intravesical BCG. All 5 patients were evaluated before therapy and quarterly thereafter by water cystometry and symptom questionnaire.
The average number of medications used daily per patient decreased from 3.2 to 1.2 after therapy. Average volumes of both first desire to void and cystometric capacity doubled after BCG. Improvement in cystometric capacity, average daytime urinary frequency, nocturia, and global pain/discomfort were statistically significant (P = 0.0277, P = 0.0131, P = 0.0199, and P = 0.0317, respectively). Three patients experienced near total relief of their symptoms with six to twelve months' follow-up (average follow-up equals 33.6 weeks).
Although the mechanism of action of BCG in interstitial cystitis is unknown, we recommend a double-blind placebo controlled trial to confirm these results and determine an optimal dosage and treatment schedule.
确定保守治疗失败的难治性间质性膀胱炎患者是否能从膀胱内卡介苗（BCG）免疫疗法中获益。
5例保守治疗失败的难治性间质性膀胱炎患者接受了为期六周的膀胱内卡介苗治疗。所有5例患者在治疗前以及之后每季度通过水囊膀胱测压法和症状问卷进行评估。
治疗后每位患者每日使用药物的平均数量从3.2降至1.2。卡介苗治疗后首次排尿欲望和膀胱测压容量的平均值均增加了一倍。膀胱测压容量、平均日间尿频、夜尿症以及总体疼痛/不适的改善具有统计学意义（P值分别为0.0277、0.0131、0.0199和0.0317）。3例患者在随访6至12个月（平均随访33.6周）后症状几乎完全缓解。
尽管卡介苗在间质性膀胱炎中的作用机制尚不清楚，但我们建议进行一项双盲安慰剂对照试验以证实这些结果，并确定最佳剂量和治疗方案。
