Cystectomy with orthotopic ileal neobladder reconstruction for treatment of bladder contracture after intravesical bacillus Calmette-Guerin therapy

Einstein (Sao Paulo). 2014 Oct-Dec;12(4):502-4. doi: 10.1590/S1679-45082014RC2794. Epub 2014 Nov 18.
[Article in English, Portuguese]

Abstract

Bladder cancer is an important health problem worldwide due to high prevalence rates and costs related to treatment. A reduction in recurrence rates has been observed since the introduction of adjuvant intravesical immunotherapy with bacillus Calmette-Guerin. There are mild complications that are easily solved by local measures and orientations. Bladder contracture, a rare and severe local complication, in some cases leading to disability, is observed primarily in patients in a maintenance program. In this article we reported the case of a male patient who underwent transurethral resection of the bladder because of a high-grade T1 urothelial carcinoma and developed this complication during treatment with bacillus Calmette-Guerin. For this reason he was submitted to cystoprostatectomy with orthotopic ileal neobladder reconstruction.

O câncer de bexiga é um importante problema de saúde mundial, tanto pelas elevadas taxas de prevalência, quanto pelos custos relacionados ao tratamento. Desde a introdução da imunoterapia intravesical adjuvante com bacilo Calmette-Guérin, vem sendo observada diminuição na taxa de recorrência. As principais complicações são de pequeno porte e simples resolução a partir de medidas locais e orientações. A bexiga contraída, uma complicação local rara e grave, mas incapacitante em alguns casos, é observada principalmente em doentes com um programa de manutenção. Relatamos aqui o caso de um paciente masculino submetido a ressecção transuretral da bexiga por um carcinoma urotelial T1 de alto grau, que desenvolveu tal complicação durante tratamento com bacilo Calmette-Guérin, sendo portanto submetido à cistoprostatectomia com realização de neobexiga ortotópica ileal.

Publication types

  • Case Reports

MeSH terms

  • Adjuvants, Immunologic / adverse effects*
  • Administration, Intravesical
  • BCG Vaccine / adverse effects*
  • Carcinoma / complications
  • Carcinoma / therapy*
  • Chemotherapy, Adjuvant / adverse effects
  • Contracture / etiology
  • Contracture / surgery*
  • Cystectomy / methods*
  • Cystitis / surgery
  • Humans
  • Ileum / surgery
  • Male
  • Middle Aged
  • Treatment Outcome
  • Urinary Bladder Diseases / etiology
  • Urinary Bladder Diseases / surgery*
  • Urinary Bladder Neoplasms / complications
  • Urinary Bladder Neoplasms / therapy*
  • Urinary Bladder*
  • Urinary Diversion / methods

Substances

  • Adjuvants, Immunologic
  • BCG Vaccine