Abstract
We report a rare case of severe bladder-referred pain and allodynia in the lower abdominal skin and perineum 12 weeks after intravesical bacillus Calmette-Guérin (BCG) therapy was performed for a patient's superficial bladder cancer. This is the first report of a prolonged complication after intravesical BCG therapy.
An 88-year-old woman was admitted with a complaint of pollakiuria. Her illness was diagnosed as superficial bladder cancer by cytodiagnosis, and transurethral electro-resection of the bladder tumor (TUR-Bt) was performed. She underwent intravesical BCG therapy for recurrent superficial bladder tumor twice a year. During the intravesical BCG therapies, she complained of severe bladder irritability, but non-steroidal anti-inflammatory drugs (NSAIDs) had some favorable effects. Twelve weeks after the second intravesical BCG therapy was finished, severe pain and allodynia occurred in her lower abdominal skin and perineum. At the time of our first examination, the regions of the pain and allodynia shaped an inverted triangle below the navel on her lower abdomen, constricting to the perineum. These regions coincided with regions at which bladder-and kidney-referred pain are known to occur. Oral administration of morphine was started and was quite effective. Currently, she is almost free of pain under morphine.
