Factores predictivos del desarrollo de estenosis uretral en pacientes con tumor vesical: el papel de la terapia intravesical con BCG

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas Pub Date : 2026-05-01 Epub Date: 2025-12-18 DOI:10.1016/j.acuro.2025.501908

İ.E. Ergín , A. Sanci , E. Hepşen , K. Sarıkaya , M. Yığman , A.L. Sağnak , A.N. Karakoyunlu

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引用次数: 0

Abstract

Objective

This study aims to investigate the predictive role of intravesical Bacillus Calmette-Guérin (BCG) therapy on urethral stricture development in male patients undergoing bladder tumor surveillance, while also assessing the impact of repeated urethral instrumentation on stricture risk.

Methods

This retrospective study included male patients aged 18–90 with non-muscle invasive bladder tumors followed between 2018 and 2024. Demographics, cystoscopy and TUR procedures, intravesical treatments (BCG and chemotherapy), and urethral stricture diagnosis were recorded. Urethral stricture was confirmed by uroflowmetry, cystoscopy, and urethrography. Patients with prior urethral stricture or incomplete records were excluded. Statistical analyses included logistic regression to identify predictors of stricture development, adjusting for age and comorbidities. Sample size was calculated to ensure adequate power to detect a 15% difference in stricture incidence related to BCG therapy.

Results

A total of 187 male patients were analyzed, with a 12.3% urethral stricture incidence. BCG therapy was administered to 32.6% of patients and significantly increased stricture risk (OR: 4.11, p = 0.015). Each additional dose was associated with an increased risk (OR: 2.11, p = 0.001). TURP (OR: 2.95, p = 0.045) and the number of cystoscopies (OR: 1.42 per procedure, p = 0.040) were also significant predictors. Tumor size ≥3 cm was associated with higher risk (OR: 1.88, p = 0.037). Spearman analysis showed positive correlations between stricture severity and both BCG doses and cystoscopy number.

Conclusion

Intravesical BCG therapy, repeated cystoscopies, and TURP increase urethral stricture risk in bladder tumor patients. Preventive measures and careful monitoring are essential to reduce urethral complications.

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膀胱肿瘤患者尿路狭窄发展的预测因素：卡介苗静脉治疗的作用

目的探讨膀胱内卡介苗（BCG）治疗对男性膀胱肿瘤监测患者尿道狭窄发展的预测作用，同时评估反复尿道内固定对尿道狭窄风险的影响。方法回顾性研究纳入2018 - 2024年间18-90岁男性非肌肉浸润性膀胱肿瘤患者。统计数据、膀胱镜检查和TUR手术、膀胱内治疗（BCG和化疗）以及尿道狭窄诊断。经尿流术、膀胱镜及尿道造影证实尿道狭窄。排除既往有尿道狭窄或记录不完整的患者。统计分析包括逻辑回归，以确定结构发展的预测因素，调整年龄和合并症。计算样本量以确保有足够的能力检测出与卡介苗治疗相关的15%的狭窄发生率差异。结果本组共收治男性患者187例，尿道狭窄发生率为12.3%。32.6%的患者接受卡介苗治疗，狭窄风险显著增加（OR: 4.11, p = 0.015）。每增加一次剂量与风险增加相关（OR: 2.11, p = 0.001）。TURP （OR: 2.95, p = 0.045）和膀胱镜检查次数（OR: 1.42, p = 0.040）也是显著的预测因素。肿瘤大小≥3cm与较高的风险相关（OR: 1.88, p = 0.037）。Spearman分析显示，卡介苗剂量和膀胱镜检查次数与狭窄严重程度呈正相关。结论膀胱肿瘤患者膀胱内卡介菌治疗、反复膀胱镜检查和TURP治疗增加了尿道狭窄的风险。预防措施和仔细监测对减少尿道并发症至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Actas urologicas espanolas UROLOGY & NEPHROLOGY-

CiteScore

1.90

自引率

0.00%

发文量

审稿时长

46 days

期刊介绍： Actas Urológicas Españolas is an international journal dedicated to urological diseases and renal transplant. It has been the official publication of the Spanish Urology Association since 1974 and of the American Urology Confederation since 2008. Its articles cover all aspects related to urology. Actas Urológicas Españolas, governed by the peer review system (double blinded), is published online in Spanish and English. Consequently, manuscripts may be sent in Spanish or English and bidirectional free cost translation will be provided.