COMPLICATIONS OF INTRACAVITARY BACILLUS-CALMETTE-GUERIN AFTER PERCUTANEOUS RESECTION OF UPPER TRACT TRANSITIONAL-CELL CARCINOMA

Percutaneous resection and intracavitary instillation of bacillus Calm ette-Guerin (BCG) is currently being used in treatment protocols in se lect patients in whom the standard nephroureterectomy for upper tract transitional cell carcinoma is undesirable. However, the complications of BCG in these patients are not well defined. Among 16 patients trea ted in this manner 4 (25%) had asymptomatic granulomatous involvement of the renal pelvis discovered during regular followup nephroscopy and biopsy: 2 had recurrent carcinoma at discovery, whereas the other 2 r emain free of disease. The significance and therapeutic consequences o f BCG granulomatosis are unknown. Continued followup is necessary to i dentify any complications of BCG therapy.