Bacillus Calmette-Guerin therapy for upper urinary tract transitional cell carcinoma using a transvesical single-j stent

Two patients with upper urinary tract transitional cell carcinoma were treated with ureteroscopic tumor ablation followed by bacillus Calmette-Guerin (BCG) therapy. Prior to the BCG therapy, a single-J stent was inserted into the renal pelvis via the percutaneous transvesical route. A dose of 240mg BCG dissolved in 120ml normal saline was administered weekly for 6 weeks. No severe side effects were observed. Both patients were tumor-free at 9- (Case 1), and 27-month (Case 2) follow-up, respectively. Although BCG instillation into the upper urinary tract has been conducted using a percutaneous nephrostomy tube, a retrograde ureteral catheter, or an indwelling double-J stent creating artificial vesicoureteral reflux, it is considered that the present method is both simple and more reliable than other methods.