Granulomatous balanitis as an unusual complication after intravesical bacillus Calmette-Guerin therapy for bladder cancer

Intravesical bacillus Calmette-Guerin (BCG) instillation is a well-established therapy for superficial bladder cancer. Urinary tract and systemic complications induced by BCG instillation have been reported by various investigators. To date, BCG-induced granulomatous balanitis has been reported only twice. Herein, we report a male patient who underwent 100 mg of Taipei-NIPM BCG intravesical instillation weekly for six consecutive doses as treatment for recurrent and chemotherapeutic-resistant superficial bladder cancer, and, two months later, developed granulomatous balanitis. The patient initially presented symptoms of anterior urethral pain and weakness of stream with progressive bullous changes over the glans penis. Granulomatous balanitis was diagnosed after an excisional biopsy was performed during the first follow-up cystoscopic examination. After three months with isoniazid treatment, these lesions totally subsided without any sequelae.