Introduction. Intravesical immunotherapy with bacillus Calmette-Guérin (BCG) is used to treat superficial bladder cancer. The incidence of mycobacterial complications does not exceed 1%, but they can occur with the involvement of the genitourinary and other organs.
Aim: to study the clinical and radiological features of tuberculosis associated with intravesical BCG therapy for bladder cancer.
Materials and methods. A total of 19 cases of tuberculosis associated with BCG therapy for bladder cancer were analyzed between January 2015 and August 2025. All patients were male, the average age was 63 years.
Results. Urogenital tuberculosis was detected in 15 patients (78.9%), respiratory system tuberculosis – in 3 (15.8%), miliary tuberculosis with the central nervous system, lungs, kidneys, ureters and bladder involvement – in 1 (5.3%). Tuberculosis of the prostate gland was detected in 11 patients (57.9%), with the epididymis involvement – in 1 (5.3%), seminal vesicles – also in 1 (5.3%), isolated tuberculous epididymitis – in 1 (5.3%). Tuberculosis of the urinary system developed in 3 patients (15.8%): the kidney tuberculosis in 2 (10.5%), tuberculosis of the bladder and right ureter in 1 (5.3%). A total of 12 patients (63.2%) were underwent surgery: 10 transurethral resections of the prostate gland or bladder, 6 epididymectomies and 1 ileocystoplasty were performed.
Conclusion. Currently, intravesical BCG immunotherapy, which has proven effective, is used to prevent relapses in all low-grade and some high-grade NMIBC. However, various mycobacterial complications are a serious complication of BCG therapy. Difficulties in diagnosing various forms of tuberculosis after BCG therapy should be noted; to confirm the diagnosis, a tissue biopsy should be performed for histopathological examination and detection of M. bovis. Patients with mycobacterial complications may require combination antituberculosis therapy for 3–12 months, as well as surgical intervention.
