Complications of immunotherapy with BCG. Report of a case with retractile bladder

OBJECTIVES: We report a case of contracted bladder following BCG immunotherapy to prevent recurrence of a superficial bladder carcinoma. Other possible complications and their prevention are also discussed. METHODS: The patient had extreme contracted bladder and marked bilateral ureterohydronephrosis that required cystectomy and bladder substitution. The histopathological examination revealed detrusor muscle fibrosis without inflammation. RESULTS: Surgery achieved good results and the patient is disease-free 5 months postoperatively. CONCLUSIONS: The major complication that must be avoided is absorption following traumatic catheterization. Recognizing the early symptoms, particularly cystitis, together with adequate and early treatment of the localized effects can significantly reduce the incidence of severe toxicity.