Intravesical instillations of BCG are recommended for the treatment of high-risk non-muscle-invasive bladder cancer. However, their prolonged use remains limited by the associated potentially serious adverse effects or complications. The purpose of this article was to provide updated recommendations for the diagnosis and management of adverse events (AEs) or complications of intravesical BCG instillations.
Review of the literature in Medline (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using the following MeSH keywords or a combination of these keywords: "bladder," "BCG," "complication," "toxicity," "adverse events," "prevention," and "treatment".
AEs or complications of BCG included genitourinary and systemic symptoms. The most common complications (cystitis, moderate fever) should be treated symptomatically and may require adjustment to allow patients to have the most complete BCG treatment possible. Serious complications are rare but must be identified promptly because of the life-threatening nature of the disease. Their management is based on the combination of anti-tuberculosis treatments, anti-inflammatory drugs and the definitive discontinuation of BCG.
The management of BCG AEs requires early identification, rational and effective treatment if necessary, and discussion of the continuation of treatment for each situation.
Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2022 Feb 03 [Epub ahead of print]
F Audenet, A Sotto, M Roumiguié, Y Allory, C Andrejak, P Leon, Y Loriot, A Masson-Lecomte, B Pradère, T Seisen, O Traxer, E Xylinas, F Bruyère, M Roupret, F Saint, Y Neuzillet
Service d'urologie, hôpital européen Georges-Pompidou, université de Paris, Paris, France., Service des maladies infectieuses et tropicales, CHU de Nîmes, Nîmes, France., Service d'urologie, CHU institut universitaire du cancer de Toulouse, Toulouse, France., Service d'anatomopathologie, institut Curie, université de Paris Saclay, Saint-Cloud, France., Service de pneumologie, CHU d'Amiens-Picardie, Amiens, France., Service d'urologie, clinique Pasteur, Royan, France., Service d'oncologie médicale, institut Gustave-Roussy, Inserm U981, Villejuif, France., Service d'urologie, hôpital Saint-Louis, université de Paris, Paris, France., Department of urology, comprehensive cancer center, medical university of Vienna, Vienna, L'Autriche., Service d'urologie, hôpital Pitié-Salpêtrière, université Paris Sorbonne, Paris, France., Service d'urologie, hôpital Bichat, université de Paris, Paris, France., Service d'urologie, hôpital Tenon, université Paris Sorbonne, Paris, France., Service d'urologie, CHRU de Tours, Tours, France., Service d'urologie, CHU d'Amiens-Picardie, Amiens, France., Service d'urologie, hôpital Foch, université de Paris Saclay, 40, rue Worth, Suresnes, France. Electronic address: .