Incidence of granulomatous prostatitis and acid-fast bacilli after intravesical BCG therapy

To determine the incidence of granulomatous prostatitis and acid-fast bacilli (AFB) after intravesical bacillus Calmette-Guérin (BCG) therapy for superficial bladder transitional cell carcinoma (TCC) or carcinoma in situ (CIS). One hundred nineteen men underwent radical cystoprostatectomy for invasi...

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Bibliographic Details
Published in:Urology (Ridgewood, N.J.) N.J.), 1997-03, Vol.49 (3), p.363-366
Main Authors: Lafontaine, Paul D., Middleman, Benton R., Graham, Sam D., Holt Sanders, W.
Format: Article
Language:English
Subjects:
Adjuvants, Immunologic - adverse effects
Administration, Intravesical
BCG Vaccine - adverse effects
Biological and medical sciences
Carcinoma in Situ - therapy
Carcinoma, Transitional Cell - therapy
Granuloma - complications
Granuloma - epidemiology
Granuloma - microbiology
Granuloma - pathology
Humans
Incidence
Male
Medical sciences
Nephrology. Urinary tract diseases
Prostatitis - complications
Prostatitis - epidemiology
Prostatitis - microbiology
Prostatitis - pathology
Tumors of the urinary system
Urinary Bladder Neoplasms - therapy
Urinary tract. Prostate gland
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Summary:To determine the incidence of granulomatous prostatitis and acid-fast bacilli (AFB) after intravesical bacillus Calmette-Guérin (BCG) therapy for superficial bladder transitional cell carcinoma (TCC) or carcinoma in situ (CIS). One hundred nineteen men underwent radical cystoprostatectomy for invasive bladder cancer from January 1, 1980 through December 31, 1995. Twelve patients had received intravesical BCG therapy before undergoing cystoprostatectomy. Nine men who did not receive intravesical BCG therapy before undergoing cystoprostatectomy served as controls. The surgical specimens were examined with a Ziehl-Neelsen stain for the presence of granulomatous prostatitis and for the presence of AFB. Granulomatous prostatitis was identified in 9 of 12 patients (75%) who had received intravesical BCG therapy. AFB were identified in 7 of 9 patients (77%) with granulomatous prostatitis. Pathologic evidence of granulomatous prostatitis with AFB is a common occurrence after intravesical BCG therapy and its incidence is far greater than the reported incidence of symptomatic granulomatous prostatitis. AFB discovered during the evaluation of either an increased level of prostate-specific antigen or prostate nodule in otherwise asymptomatic men may require no specific therapy.
ISSN:0090-4295
1527-9995
DOI:10.1016/S0090-4295(96)00507-9