Abstract

"Purpose: To evaluate the clinical significance of granulomatous prostatitis (GnP) after intravesical bacillus Calmette-Guerin (BCG) therapy (GnP-BCG) for superficial bladder transitional cell carcinoma or carcinoma in situ. Materials and Methods: We reviewed the medical records and transrectal ultrasonography (TRUS) of 193 patients who had undergone transurethral resection of bladder tumor and had received intravesical BCG therapy from January, 2003 through to December, 2009. Among them, 19 patients underwent prostate biopsy due to elevated prostate specific antigen (PSA) or abnormal TRUS finding. Results: Six of 19 patients (31.5%) who had sustained symptom were identified as GnP, of whom one patient had concurrent prostate cancer. The other 5 patients’ symptoms were spontaneously resolved and their PSA normalized by conservative care. Conclusions: Since GnP-BCG has a similar clinical appearance to prostate cancer, we should differentiate GnP-BCG from prostate cancer. However, the natural history of GnP-BCG is that of slow and complete resolution after conservative treatment. We suggest conservative treatment before undergoing prostate biopsy in patients with BCG immunotherapy to reduce unnecessary invasive intervention."

• Keywords: Prostatitis, BCG vaccine, Prostate specific antigen