尿管ステントを留置しBCG療法を施行した膀胱および両側上部尿路上皮内癌

Bladder and Bilateral Upper Urinary Tracts Carcinoma in situ Treated by Bacillus Calmette-Guerin Therapy Utilizing Bilateral Ureteral Stents

　72歳，男性。膀胱腫瘍に対し経尿道的膀胱腫瘍切除術を施行した。同時に膀胱および両側上部尿路上皮内癌を診断したため，両側尿管に6Fr尿管ステントを留置して人工的に膀胱尿管逆流を誘発し，BCG療法を行った。BCG 80mgを生理食塩水80mlに溶解し週1回，計8回膀胱内に注入した。尿細胞診は5回目の注入後より陰性化した。重篤な副作用は発生せず，治療から1年4か月を経過するが腫瘍再発を認めていない。

A 72-year-old man underwent transurethral resection of bladder tumor. Simultaneously, carcinoma in situ of the bladder and bilateral upper urinary tracts was disclosed. Bilateral vesicoureteral reflux was induced by placing ureteral stents and 80mg of bacillus Calmette-Guerin (Tokyo 172 strain) in 80ml of saline was intravesically instilled. The treatment was repeated weekly for 8 weeks. He received isoniazid (200 mg/day) for 3 days after every instillation. Intolerable side effects did not occur. The urine cytology became negative after the 5th instillation.