上部尿路上皮内癌に対して尿管ステントカテーテルを留置したBCG膀胱内注入療法

INTRAVESICAL BACILLUS CALMETTE-GUERIN THERAPY FOR CARCINOMA IN SITU OF BLADDER AND BILATERAL UPPER URINARY TRACT UTILIZING INDWELLING URETERAL STENTS

　上部尿路の上皮内癌に対して，膀胱尿管逆流（VUR）を利用したBCGの局所灌流を施行し，満足すべき結果を得た。症例は60歳，男性。両側尿管内にダブル—Jカテーテルを留置しVURの発生を確認した。BCGは週1回8週間膀胱内に注入した。BCG投与開始12週目より排泄尿細胞診は陰性化し，1年9か月を経過した現在，腫瘍再発を認めない。経過中，重篤な副作用は認めなかった。

We successfully treated a 60 year-old male patient with carcinoma in situ of bladder and bilateral upper urinary tract by intracavital bacillus Calmette-Guerin (BCG) therapy. Prior to the BCG therapy double-J catheters were indwelt in the bilateral ureter to create vesicoureter-al reflex. BCG was administrated intravesicaly once a week for 8 weeks. Positive urinary cytology became negative 12 weeks after the BCG therapy. The patient remained tumor free at 21 month post treatment as confirmed by bladder mucosal biopsy and irrigation cytology of upper urinary tracts.