Abstract
The urologist must prevent, identify and properly treat the complications of intravesical chemotherapy and immunotherapy. Both local and systemic toxicity of adjuvant intravesical therapy is herein analyzed. Topical toxicity is mainly due to the inflammation induced by the contact between the instilled agent and the bladder mucosa. Material and Methods The factors predisposing to topical toxicity must be identified and removed before starting the treatment. The choice of the agent, its dose, concentration and dosage must be tailored, whenever possible, to the presence of the above mentioned factors. Mitomycin and BCG can rarely provoke chronic cystitis, severely compromising bladder function. Results The most dangerous complication of early intravesical chemotherapy is the instillation in presence of an unrecognized bladder perforation. Flu-like syndrome, fever, chills, arthralgia are reported in almost 20% of patients receiving BCG. If fever persists for more than 48 hours or exceeds 38.5 °C, isoniazid must be administered and BCG stopped until complete remission. BCG sepsis is a rare but severe complication that must be promptly recognized and treated. If not, a life-threatening multi-organ failure syndrome can arise. Isoniazid and rifampicin, adding ethambutol when required, must be administered for a prolonged period until complete remission. Conclusions Granulomatous lesions represent the main other rare systemic complications of BCG therapy. Systemic toxicity of intravesical chemotherapy is rare, due to the high molecular weight of the drugs, limiting systemic absorption.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.