Complications of intracavitary bacillus Calmette-Guerin after percutaneous resection of upper tract transitional cell carcinoma.

Percutaneous resection and intracavitary instillation of bacillus Calmette-Guerin (BCG) is currently being used in treatment protocols in select patients in whom the standard nephroureterectomy for upper tract transitional cell carcinoma is undesirable. However, the complications of BCG in these patients are not well defined. Among 16 patients treated in this manner 4 (25%) had asymptomatic granulomatous involvement of the renal pelvis discovered during regular followup nephroscopy and biopsy: 2 had recurrent carcinoma at discovery, whereas the other 2 remain free of disease. The significance and therapeutic consequences of BCG granulomatosis are unknown. Continued followup is necessary to identify any complications of BCG therapy.