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Does asymptomatic bacteriuria affect the response to intravesical bacillus Calmette–Guérin?
Author(s) -
Herr Harry
Publication year - 2020
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.14139
Subject(s) - medicine , bladder cancer , asymptomatic , bacteriuria , cystoscopy , urology , asymptomatic bacteriuria , urine , bacillus (shape) , gastroenterology , urinary bladder , urinary system , surgery , cancer , microbiology and biotechnology , biology
Objective To determine the initial response to intravesical bacillus Calmette–Guérin and the 3‐year recurrence rate of high‐risk non‐muscle‐invasive bladder cancer in patients who have asymptomatic bacteriuria. Methods Response and recurrence rates were investigated in 505 patients with high‐risk non‐muscle‐invasive bladder cancer after treatment with induction bacillus Calmette–Guérin (TICE strain) therapy. Initial response was determined after 3 months and patients were followed every 3–6 months for 3 years. Before bacillus Calmette–Guérin and each follow‐up cystoscopy, urine cultures were obtained, stratified as no growth, <104, >104 or >105 colony‐forming unit/mL. Any degree of bacteriuria on culture was classified as asymptomatic bacteriuria. Results Of the 505 cases, 270 (53%) had asymptomatic bacteriuria. A total of 89% of patients with asymptomatic bacteriuria showed a complete response to bacillus Calmette–Guérin versus 76% of uninfected patients ( P = 0.001), and 75% of bacteriuric patients survived tumor‐free for 3 years versus 65% of uninfected patients. Conclusions Chronic bacteriuria might enhance the response of high‐risk non‐muscle‐invasive bladder cancer to intravesical bacillus Calmette–Guérin and result in longer tumor‐free survival than uninfected patients.