Bacillus Calmette-Guérin (BCG) immunotherapy is the most effective treatment for carcinoma in situ and high-risk non-muscle invasive bladder cancer (NMIBC). However, it can also provoke diverse side effects. We found 1 patient with a significantly and rapidly reduced bladder volume after the instillation of BCG. Few such cases and corresponding treatments have been reported. We speculated that the tuberculosis infection existed, so antitubercular therapy was given. After a 3-month oral intake of rifampicin, isoniazid, and ofloxacin, the volume of bladder returned to normal and the voiding symptoms disappeared. This case indicated that the reduction of bladder volume caused by BCG instillation could be treated with antitubercular therapy. Prompt and accurate diagnosis was important for the management.

1.
Babjuk
M
,
Burger
M
,
Compérat
EM
,
Gontero
P
,
Mostafid
AH
,
Palou
J
, et al.
European association of urology guidelines on non-muscle-invasive bladder cancer (TaT1 and carcinoma in situ): 2019 Update
.
Eur Urol
.
2019
;
76
(
5
):
639
57
.
2.
Rischmann
P
,
Desgrandchamps
F
,
Malavaud
B
,
Chopin
DK
.
BCG intravesical instillations: recommendations for side-effects management
.
Eur Urol
.
2000
;
37
(
Suppl 1
):
33
6
.
3.
Bohle
A
,
Balck
F
,
von Weitersheim
J
,
Jocham
D
.
The quality of life during intravesical bacillus Calmette-Guerin therapy
.
J Urol
.
1996
;
155
(
4
):
1221
6
.
4.
Lamm
DL
,
van der Meijden
PM
,
Morales
A
,
Brosman
SA
,
Catalona
WJ
,
Herr
HW
, et al.
Incidence and treatment of complications of bacillus Calmette-Guerin intravesical therapy in superficial bladder cancer
.
J Urol
.
1992
;
147
(
3
):
596
600
.
5.
Colombel
M
,
Saint
F
,
Chopin
D
,
Malavaud
B
,
Nicolas
L
,
Rischmann
P
.
The effect of ofloxacin on bacillus Calmette-Guerin induced toxicity in patients with superficial bladder cancer: results of a randomized, prospective, double-blind, placebo controlled, multicenter study
.
J Urol
.
2006
;
176
(
3
):
935
9
.
6.
Brausi
M
,
Oddens
J
,
Sylvester
R
,
Bono
A
,
van de Beek
C
,
van Andel
G
, et al.
Side effects of Bacillus Calmette-Guérin (BCG) in the treatment of intermediate- and high-risk Ta, T1 papillary carcinoma of the bladder: results of the EORTC genito-urinary cancers group randomised phase 3 study comparing one-third dose with full dose and 1 year with 3 years of maintenance BCG
.
Eur Urol
.
2014
;
65
(
1
):
69
76
.
7.
Oddens
J
,
Brausi
M
,
Sylvester
R
,
Bono
A
,
van de Beek
C
,
van Andel
G
, et al.
Final results of an EORTC-GU cancers group randomized study of maintenance bacillus Calmette-Guérin in intermediate- and high-risk Ta, T1 papillary carcinoma of the urinary bladder: one-third dose versus full dose and 1 year versus 3 years of maintenance
.
Eur Urol
.
2013
;
63
(
3
):
462
72
.
8.
Witjes
JA
,
Palou
J
,
Soloway
M
,
Lamm
D
,
Brausi
M
,
Spermon
JR
, et al.
Clinical practice recommendations for the prevention and management of intravesical therapy-associated adverse events
.
Eur Urol Suppl
.
2008
;
7
(
10
):
667
74
.
9.
Homma
Y
,
Ueda
T
,
Tomoe
H
,
Lin
AT
,
Kuo
HC
,
Lee
MH
, et al.
Clinical guidelines for interstitial cystitis and hypersensitive bladder updated in 2015
.
Int J Urol
.
2016
;
23
(
7
):
542
9
.
10.
van de Merwe
JP
,
Nordling
J
,
Bouchelouche
P
,
Bouchelouche
K
,
Cervigni
M
,
Daha
LK
, et al.
Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: an ESSIC proposal
.
Eur Urol
.
2008
;
53
(
1
):
60
7
.
11.
Grossman
HB
.
Bladder contracture following intravesical BCG immunotherapy
.
Urology
.
1993
;
41
(
4
):
353
5
.
12.
Garcia
C
,
Jina
H
,
Bergersen
P
,
Chalasani
V
.
Bladder contracture: a rare and serious side effect of intravesical bacillus Calmette-Guérin therapy
.
Urol Case Rep
.
2015
;
4
:
22
4
.
13.
Numakura
K
,
Tsuchiya
N
,
Tsuruta
H
,
Akihama
S
,
Saito
M
,
Inoue
T
, et al.
Efficacy and safety of bladder hydrodistension for decreased bladder capacity induced by intravesical BCG therapy
.
Scand J Urol
.
2016
;
50
(
6
):
429
32
.
14.
Wittes
R
,
Klotz
L
,
Kosecka
U
.
Severe bacillus Calmette-Guerin cystitis responds to systemic steroids when antituberculous drugs and local steroids fail
.
J Urol
.
1999
;
161
(
5
):
1568
9
.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.