[Bladder tumour treatment: the real BCG definitive contra-indications].

The contra-indications of BCG instillations were described at commercialization in 1996 and have not been revised since. The objective of this review has been to revise the rational of the contra-indications of BCG and then to review the reported cases of transgressions against them. The definite contra-indication remain: a history of systemic reaction to BCG, tuberculosis, fever with unknown etiology, alteration of the urine/blood barrier from trauma or cystitis (infectious or radiation), the deficits of cellular immunity, the combined deficits and defects in phagocytosis. However, there were no serious adverse effects of BCG therapy with immunosuppressive treatment for organ transplantation or in case of chronic inflammatory disease, nor with previous irradiation of the bladder area without radiation cystitis. These specific circumstances require more studies and data if they are no longer to be considered as a contra-indication.