Intravesical Bacillus Calmette-Guerin for treatment of refractory interstitial cystitis

[Bacillus Calmette-Guerin (BCG) was first used as a tuberculosis vaccine. It is thought to mount a local immune reaction, and is a therapy for superficial bladder cancer that frequently prevents recurrence. “Refractory” means has not responded to therapy.]

Journal: Urology Journal. 2007 Winter;4(1):18-23.

Authors and affiliation: Aghamir SM, Mohseni MG, Arasteh S. Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

PMID: 17514606

Introduction: The aim of this study was to examine the efficacy and safety of intravesical Bacillus Calmette-Guerin (BCG) in the treatment of refractory interstitial cystitis (IC).

Materials and methods: Thirteen patients with refractory IC were enrolled in the study. They were scheduled to receive 6 weekly courses of treatment with intravesical BCG. Variables including the frequency, nocturia, urgency, pelvic pain, dyspareunia, dysuria, IC symptom index, IC problem index, and average voided volume were assessed every 6 months after the BCG therapy.

Results: Thirteen patients received the complete course of intravesical BCG therapy. Twenty-four months after the treatment:

  • A mean improvement of 51.9% was seen in frequency (P=.001),
  • 43.2% in nocturia (P=.002),
  • 28.7% in urgency (P=.004),
  • 43.1% in pelvic pain (P=.001),
  • 58.3% in dyspareunia (P=.003),
  • 6.5% in dysuria (P=.16),
  • 57.7% in the O'Leary-Sant IC symptom index (P=.001),
  • And 61.8% in the O'Leary-Sant IC problem index (P=.001) scores.

A significant improvement was seen in the mean average voided volume at the 24th follow-up month (89.5%; P=.001).

Conclusion: Intravesical BCG is a relatively effective treatment in patients with refractory IC. Its efficacy seems to be modest and lasts for at least 24 months in majority of the patients. It is also safe and well tolerated.

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