BCG膀胱内注入後の萎縮膀胱

SEVERELY CONTRACTED BLADDER FOLLOWING INTRAVESICAL INSTILLATION OF BACILLUS CALMETTE GUERIN AFTER TUR-BT

　患者は54歳の男性。1985年7月膀胱腫瘍と診断され，以来，経尿道的膀胱腫瘍切除術，膀胱内注入療法などを行った。1991年1l月広範囲の多発性再発に対し，経尿道的膀胱腫瘍切除術を施行，術後1,2週目にBCGを膀注したところ，高度の膀胱刺激症状が出現し，尿中結核菌が陽性となった。抗結核療法を施行したが，著明な萎縮膀胱となり，改善がみられず，移行上皮癌の再発も認めたので，1992年6月膀胱全摘術を施行した。

A 54-year-old male, who had repeatedly received TUR-Bt, intravesical instillations, systemic chemother-apy, and radiation therapy for recurrent bladder tumor in five years, appeared with another recurrent bladder tumor in November, 1991.

He underwent the seventh TUR-Bt over a wide area and intravesical administration of BCG (80 mg at each instillation) at one and two weeks after TUR-Bt, which induced severely irritable bladder. Because of positive tubercle bacillus (TB) in urine, antituberculous chemotherapy consisting of INH and RFP was given. Although the chemotherapy achieved negative TB in urine, the bladder severely contracted.