IJU case reports · 2025
A Case of Complete Remission of Bilateral Upper Tract Carcinoma In Situ Following Retrograde Bacillus Calmette-Guérin (BCG) Instillation via Open-Ended Ureteral Catheters After Failure Using Double-J Stents.
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Katsurayama Nanaka, Horiuchi Toshihide, Nishimura Koichi, Nakamura Kazutaka, Endo Takanori, Nemoto Yuki, Nakajima Nao, Toki Daisuke, Kondo Tsunenori
Аннотация
INTRODUCTION: We present a case of carcinoma in situ (CIS) of the bilateral upper urinary tract (UUT) in which long-term complete remission was achieved through retrograde perfusion of Bacillus Calmette-Guérin (BCG) via open-ended ureteral catheters following the failure of endoluminal therapy using double-J stents.
CASE PRESENTATION: A 52-year-old male patient was diagnosed with CIS of the bilateral UUT and bladder. Intravesical BCG instillation using double-J stents failed to eradicate persistently positive catheter urine cytology from the bilateral UUT. Since the patient strongly desired kidney-sparing treatment, retrograde BCG perfusion via open-ended ureteral catheter was performed. This treatment resulted in durable complete remission lasting 3 years.
CONCLUSIONS: Retrograde BCG treatment via double-J stent may result in suboptimal efficacy due to limited drug exposure to the UUT urothelium. In cases in which kidney-sparing treatment is required, retrograde BCG perfusion via open-ended ureteral catheters may be considered a viable therapeutic option.
CASE PRESENTATION: A 52-year-old male patient was diagnosed with CIS of the bilateral UUT and bladder. Intravesical BCG instillation using double-J stents failed to eradicate persistently positive catheter urine cytology from the bilateral UUT. Since the patient strongly desired kidney-sparing treatment, retrograde BCG perfusion via open-ended ureteral catheter was performed. This treatment resulted in durable complete remission lasting 3 years.
CONCLUSIONS: Retrograde BCG treatment via double-J stent may result in suboptimal efficacy due to limited drug exposure to the UUT urothelium. In cases in which kidney-sparing treatment is required, retrograde BCG perfusion via open-ended ureteral catheters may be considered a viable therapeutic option.