Intravesical Bacillus Calmette-Guerin Shows Limited Efficacy in the Treatment of Interstitial Cystitis

摘要

Objectives: Interstitial cystitis (1C) is a disease with an elusive etiology that has proved refractory to numerous forms of treatment. A pilot clinical trial suggested that intravesical treatment with Tice strain Bacillus Calmette-Guerin (BCG) is a safe and effective treatment for 1C. We report our prospective long-term, single-center clinical experience with the use of BCG for 1C.Materials and Methods: Eighteen consecutive patients meeting the National Institute of Diahetes & Digestive & Kidney Diseases (NIDDK) criteria for 1C who elected to receive 6 weekly instillations of BCG were studied. Outcomes included self-reported response to treatment and voiding diaries at 6, 12, 18, 24, 36, and 48 months, with a mean follow up of 37 months (range, 27-51).Results: Six of 18 patients (33%) reported a 50% or greater improvement in any 1 of 3 clinical parameters (urgency, frequency, and pain and relief with voiding) at 6 months. The effect lasted until 12 months in 4 patients (22%), until 18 months in 3 patients (17%), until 24 months in 2 patients (11%), and until 36 months in a single patient (8.3%). Complications of BCG treatment included self-limited flu-like symptoms in 3 patients. Thirteen of 18 patients (72%) who received BCG treatment have gone on to require subsequent procedures, including cystectomy. Conclusions: Our clinical experience indicates that intravesical Tice strain BCG could have a short-term effect for IC patients, which is not sustained with longer follow up. Management usually requires adjuvant therapy after initial treatment. Accordingly, we do not recommend BCG as a long-term single-modality treatment for IC.