Abstract
Bacillus Calmette-Guerin (BCG) is an attenuated strain of Mycobacterium bovis (M. bovis) that has been used to treat transitional cell carcinoma. Since the initial report by Morales and associates on the use of intravesical BCG for the treatment of recurrent superficial bladder tumors, intravesical therapy with BCG has proved to be more effective for prophylaxis and the treatment of superficial bladder tumors and carcinoma in situ than most of the standard chemotherapeutic agents. While the majority of patients tolerate BCG treatments well, a number of adverse reaction (e.g., fever, hematuria, dysuria, nausea and malaise) have been reported. More serious complications occur on rare occasions and they include pneumonitis/hepatitis, ureteral obstruction, renal abscess and sepsis. We report here on a case of ureteral obstruction that was caused by periureteral tuberculous granuloma after intravesical BCG therapy for superficial bladder tumors, and the condition required distal ureterectomy & ureteroneocystostomy.
Figures and Tables
Fig. 1
(A) Abdominal CT at preoperative (TURBT) shows no specific finding except for the contrast media-filled intestine because of a prior former barium enema. (B) The preoperative a abdominal CT (distal ureterectomy & ureteroneocystostomy) shows obstruction of the left lower ureter with circular calcification after BCG instillation.
![kju-47-436-g001](/upload/SynapseData/ArticleImage/1020kju/kju-47-436-g001.jpg)
Fig. 2
Gross finding of periureteric soft tissue shows pale yellow caseous necrosis, about 2.7×2.0cm on the cross diameter.
![kju-47-436-g002](/upload/SynapseData/ArticleImage/1020kju/kju-47-436-g002.jpg)
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