Peritoneal tuberculosis caused by intravesical instillation with Bacillus Calmette-Guérin (BCG) following nephroureterectomy in a patient with bladder and upper tract urothelial cancer: a case report

ABSTRACT

Background

The standard treatment for high-risk non-muscle-invasive bladder cancer (NMIBC) is trans-urethral resection of the bladder (TURB) followed by instillation of Bacillus Calmette-Guérin (BCG). The occurrence of peritoneal tuberculosis after intravesical BCG instillation is extremely rare and difficult to diagnose.

Methods

We report the case of a 79-year-old man with urothelial cell carcinoma (UCC) of the kidney and bladder who developed peritoneal tuberculosis after consecutive TURB and nephroureterectomy followed by intravesical BCG instillation. Further investigation revealed an undiagnosed bladder leak.

Conclusion

This case serves as a reminder for urologists to be suspicious for urothelium discontinuity when administering BCG shortly after bladder surgery.

KEYWORDS:

• Nephroureterectomy
• Bacillus Calmette-Guérin
• urothelial cell carcinoma
• bladder cancer
• peritoneitis
• tuberculosis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Consent

The authors confirm to have obtained written informed consent to publish the details from the affected individual.