Skip to main content
SpringerLink
Log in

Endoscopic Perforation and Complications of BCG Therapy

  • Chapter
Urological Emergencies

Part of the book series: Current Clinical Urology ((CCU))

  • 2184 Accesses

Abstract

Minimally invasive and organ-sparing treatments for benign and malignant conditions have improved therapeutic outcomes and quality of life, but unique adverse events are associated with these interventions. The endoscopic treatment of bladder cancer may cause morbidity as a result of disease progression, intraoperative complications, and side effects of therapy. Acute bleeding and ureteral obstruction owing to tumor progression or therapy are reviewed elsewhere in this book (Chapters 13 and 18). Bladder perforation during transurethral resection can lead to tumor dissemination, abdominal distension, and permanent bladder fibrosis. During percutaneous upper urinary tract surgery, injury to the colon, duodenum, lung and great vessels can lead to life-threatening infection, pulmonary compromise, and exsanguination. Systemic infection with bacillus calmette geurin (BCG) during the course of immunotherapy for bladder or upper tract urotehlial cancer, although rare, may lead to fatal sepsis if not promptly recognized and aggressively treated.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 179.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Dick A, Barnes R, Hadley H, Bergman RT, Ninan CA. Complications of transurethral resection of bladder tumors: prevention, recognition and treatment. J Urol 1980; 124(6): 810–811.

    PubMed  CAS  Google Scholar 

  2. Mitchell JP. Transurethral resection for neoplasm of the bladder. In: Endoscopic Operative Urology. (Wright PSG, ed.), Bristol, UK, 1981, pp. 341–363.

    Google Scholar 

  3. Collado A, Chechile GE, Salvador J, Vicente J. Early complications of endoscopic treatment for superficial bladder tumors. J Urol 2000; 164: 1529–1532.

    Article  PubMed  CAS  Google Scholar 

  4. Siegler LJ, Addonidio JC, Fernandez R, Shutte H. Incidence and treatment of bladder perforation following bladder biopsy. Urol 1985; 26(1): 10–11.

    Article  Google Scholar 

  5. Richardson JR Jr, Leadbetter GW Jr. Non-operative treatment of the ruptured bladder. J Urol 1975; 114: 213–216.

    PubMed  Google Scholar 

  6. Mulkey AP Jr, Witherington R. Conservative management of vesical rupture. Urology 1974; 5: 426–430.

    Article  Google Scholar 

  7. Mydlo JH, Weinstein R, Shah S, et al. Long-term consequences from bladder perforation and/or violation in the presence of transitional cell carcinoma: results of a small series and a review of the literature. J Urol 1999; 161(4): 1128–1132.

    Article  PubMed  CAS  Google Scholar 

  8. Ohguchi N, Sakaida N, Okamura A, et al. Extravesical tumor implantation caused by perforation during transurethral resection of a bladder tumor: a case report. Int J Urol 1997; 4(5): 516–518.

    Article  PubMed  CAS  Google Scholar 

  9. Ekengren J, Conner P, Lindholm M, Halm RG. Fluid absorption during transurethral bladder surgery. Scand J Urol Nephrol 1995; 29(4): 519–520.

    PubMed  CAS  Google Scholar 

  10. Vansonnenberg E, Mueller PR, Ferrucci JT Jr. Percutaneous drainage of 250 abdominal abscesses and fluid collections. Radiology 1984; 151: 337–341.

    PubMed  CAS  Google Scholar 

  11. Shuster TG, Hollenbeck BK, Faerber GJ, Wolf JS Jr. Complications of ureteroscopy: analysis of predictive factors. J Urol 2001; 166(2): 538–540.

    Article  Google Scholar 

  12. Hollenbeck BK, Shuster TG, Faerber GJ, Wolf JS Jr. Comparison of outcomes of ureteroscopy for ureteral calculi above and below the pelvic brim. Urol 2001; 58(3): 351–356.

    Article  PubMed  CAS  Google Scholar 

  13. Jeromin L, Sosnowski M. Ureteroscopy in the treatment of ureteral stones: over 10 years experience. Eur Urol 1998; 34(4): 344–349.

    Article  PubMed  CAS  Google Scholar 

  14. Harmon WJ, Serson PD, Blute ML, Patterson DE, Segura JW. Ureteroscopy: current practice and long term complications. J Urol 1997; 157(1): 28–32.

    Article  PubMed  CAS  Google Scholar 

  15. Francesca F, Scattoni V, Nava L, et al. Failures and complications of transurethral ureteroscopy in 297 cases: conventional rigid instruments vs small caliber semirigid ureteroscopes. Eur Urol 1995; 28: 112–115.

    PubMed  CAS  Google Scholar 

  16. Kranolowsky EV. Ureteral perforation during ureterorenoscopy: treatment and management. J Urol 1987; 138: 36–38.

    Google Scholar 

  17. Peh OH, Lim PH, Ng FC, et al: Holmium laser lithotripsy in the management of ureteric calculi. Ann Acad Med Singapore 2001; 30(6): 563–567.

    PubMed  CAS  Google Scholar 

  18. Assimos DG, Patterson LC, Taylor CL. Changing incidence and etiology of iatrogenic ureteral injuries. J Urol 1994; 152(6): 2240–2246.

    PubMed  CAS  Google Scholar 

  19. Andersen JR, Ostri P, Jansen JE, Kristensen JK. A retrospective evaluation of 691 ureteroscopies: indications, procedures, success rate and complications. Urol Int 1993; 51(4): 191–197.

    PubMed  CAS  Google Scholar 

  20. Kostakopoulos A, Sofras F, Karayiannis A, Kranidis A, Dimopoulos C. Ureterolithotripsy: report of 1000 cases. Br J Urol 1989; 63(3): 243–244.

    PubMed  CAS  Google Scholar 

  21. Houffman JL. Ureteroscopic injuries to the upper urinary tract. Urol din North Am 1989; 16(2): 249–254.

    Google Scholar 

  22. Weinberg JJ, Ansong K, Smith AD. Complications of ureteroscopy in relation to experience: a reported survey and author experience. J Urol 1987; 137: 384.

    PubMed  CAS  Google Scholar 

  23. Stoller ML, Wolf JS Jr, Hofman R, et al. Ureteroscopy without balloon dilation: an outcome assessment. J Urol 1992; 147: 1238.

    PubMed  CAS  Google Scholar 

  24. Teichman JM, Rao RD, Rogenes VJ, Harris JM. Ureteroscopic management of ureteral calculi: electrohydraulic vs holmium: YAG lithotripsy. J Urol 1997; 158(4): 1357–1361.

    Article  PubMed  CAS  Google Scholar 

  25. Stackl W, Marberger M. Late sequelae of the management of ureteral calculi with the ureterorenoscope. J Urol 1986; 136: 386.

    PubMed  CAS  Google Scholar 

  26. Cheung MC, Lee F, Leung YL, et al. Outpatient ureteroscopy: predictive factors for postoperative events. Urology 2001; 58(6): 914–918.

    Article  PubMed  CAS  Google Scholar 

  27. Chen YT, Chen J, Wong WY, et al. Is ureteral stenting necessary after uncomplicated ureteroscopic lithotripsy? A prospective, randomized controlled trial. J Urol 2002; 167(5): 1977–1980.

    Article  PubMed  Google Scholar 

  28. Benjamin JC, Donaldson PJ, Hill JT. Ureteric perforation after ureteroscopy. Conservative man agement. Urology 1987; 29(6): 623–624.

    Article  PubMed  CAS  Google Scholar 

  29. Lang EK. Antegrade ureteral stenting for dehiscence, stricture and fistulae. AJR Am J Roentgenol 1984; 143: 795–801.

    PubMed  CAS  Google Scholar 

  30. McDonald JH, Falons JA. Experimental ureteral stricture: ureteral regrowth following ureterotomy with and without intubation. J Urol 1960; 84: 52.

    Google Scholar 

  31. Vansonncnberg E, Mueller PR, Ferrucci JT Jr. Percutaneous drainage of 250 abdominal abscesses and fluid collections. Radiology 1984; 151: 337–341.

    Google Scholar 

  32. Segura JW. Patterson DE. LeRoy AJ, Williams HJ, et al. Percutaneous removal of kidney stones: review of 1000 cases. J Urol 1985; 134: 1077.

    PubMed  CAS  Google Scholar 

  33. O’Donnell A, Scboenberger C, Weiner J, Tsou E. Pulmonary complications of percutaneous nephrostomy and kidney stone extraction. South Med J 1988; 81: 1002.

    Article  PubMed  CAS  Google Scholar 

  34. Fernstrom I, Johannson B. Percutaneous pyelithotomy. A new extraction technique. Scand J Urol Nephrol 1976; 10: 257.

    PubMed  CAS  Google Scholar 

  35. Lee WJ, Smith AD, Cubelli V, Badlani GH, et al. Complications of percutaneous nephrolithotomy. AJR Am J Roentgenol 1987; 148(1): 177–180.

    PubMed  CAS  Google Scholar 

  36. Kondas J, Szentgyorgyi E, Vaczi L, Kiss A. Splenic injury: a rare complication of percutaneous nephrolithotomy. Int Urol Nephrol 1994; 26: 399.

    Article  PubMed  CAS  Google Scholar 

  37. Leroy AJ, Williams HJ, Bender CE, Segura JW, et al. Colon perforation following percutaneous nephrostomy and renal calculus removal. Radiology 1985; 155: 83.

    PubMed  CAS  Google Scholar 

  38. Vallancien G, Capdeville R, Veillon B, Charton M, Brisset JM. Colonic perforation during per cutaneous nephrolithotomy. J Urol 1985; 134: 1185.

    PubMed  CAS  Google Scholar 

  39. Rodrigues Netto N Jr, Lemos GC, Fiuza JL. Colon perforation following percutaneous nephrolithotomy. Urology 1988; 32(3): 223–224.

    Article  PubMed  Google Scholar 

  40. Ahmed M, Reeve R. Iatrogenic duodeno-cutaneous fistula at percutaneous nephrolithotomy managed conservatively. Br J Urol 1995; 75: 416.

    Article  PubMed  CAS  Google Scholar 

  41. Carson CC, Nesbitt JA. Peritoneal extravasation during percutaneous lithotripsy. J Urol 1985; 134: 725.

    PubMed  CAS  Google Scholar 

  42. Dimberg M, Norlen H, Hoglund N, Allgen LG. Absorption of irrigating fluid during percutaneous transrenal lithotripsy. Scand J Urol Nephrol 1993; 27: 463.

    Article  PubMed  CAS  Google Scholar 

  43. Ratliff TL. The role of the immune response in bacillus Calmette-Guérin for bladder cancer. Eur Urol 1992; 21: 17–21.

    PubMed  Google Scholar 

  44. Ratliff TL, McCarthy R, Telle WB, et al. Purification of a mycobacterial adhesion for fibronectin. Infect Immunol 1993; 61: 1889–1894.

    CAS  Google Scholar 

  45. Kurota K, Brown EJ, Telle WB, et al. Characterization of bacillus Calmette-Guérin by human bladder tumor cells. J Clin Invest 1993; 91: 69–76.

    Google Scholar 

  46. Pattard JJ, Saint F, Velotti F, et al. Immune response following intravesical bacillus Calmette-Guérin instillations in superficial bladder cancer: a review. Urol Res 1998; 26: 155–159.

    Article  Google Scholar 

  47. Lamm DL, Stogdill VD, Stogdill BJ, et al. Complications of bacillus Calmette-Guérin immunotherapy in 1278 patients with bladder cancer. J Urol 1986; 135: 272–274.

    PubMed  CAS  Google Scholar 

  48. Lamm DL. Complications of bacillus Calmette-Guérin immunotherapy. Urol Clin North Am 1992; 19: 565–572.

    PubMed  CAS  Google Scholar 

  49. Lamm DL, van der Meijden PM, Morales A, et al. Incidence and treatment of complications of bacillus Calmette-Guérin intravesical therapy in superficial bladder cancer. J Urol 1992; 147: 596–600.

    PubMed  CAS  Google Scholar 

  50. Durek C, Rusch-Gerdes S, Jocham D, et al. Interference of modern antibacterials with bacillus Calmette-Guérin viability. J Urol 1999; 162: 1959–1962.

    Article  PubMed  CAS  Google Scholar 

  51. DeHaven JI, Traynellis C, Riggs DR, et al. Antibiotic and steroid therapy of massive systemic bacillus Calmette-Guérin toxicity. J Urol 1992; 147: 738–742.

    PubMed  CAS  Google Scholar 

  52. Durek C, Rusch-Gerdes S, Jocham D, et al. Sensitivity of BCG to modern antibiotics. Eur Urol 1999; 37: 21–25.

    Article  Google Scholar 

  53. Heney NM, Koontz WW, Barton B, et al. Intravesical thiotepa vs mitomycin C in patients with Ta, Tl, and TIS transitional cell carcinoma of the bladder: a phase III prospective randomized study. J Urol 1988; 140: 1390–1393.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Section of Urology, University of Arizona, Tucson, AZ

    Nathan F. E. Ullrich MD & Bruce L. Dalkin MD

  2. Section of Urology, University of Arizona, Tucson, Arizona

    Sanjay Ramakumar MD

Authors
  1. Nathan F. E. Ullrich MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sanjay Ramakumar MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bruce L. Dalkin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. University of Washington School of Medicine and Harborview Medical Center, Seattle, WA

    Hunter Wessells MD, FACS

  2. University of California School of Medicine and San Francisco General Hospital, San Francisco, CA

    Jack W. McAninch MD, FACS

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Ullrich, N.F.E., Ramakumar, S., Dalkin, B.L. (2005). Endoscopic Perforation and Complications of BCG Therapy. In: Wessells, H., McAninch, J.W. (eds) Urological Emergencies. Current Clinical Urology. Humana Press. https://doi.org/10.1385/1-59259-886-2:315

Download citation

  • DOI: https://doi.org/10.1385/1-59259-886-2:315

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-256-8

  • Online ISBN: 978-1-59259-886-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation