BCG and Intravesical Therapy: What to Expect
Intravesical therapy puts medicine (often BCG) directly into the bladder through a catheter to treat bladder cancer. You hold the medicine in the bladder for a set time, then urinate it out. Treatments are usually given once a week for several weeks.
Before your procedure
- Limit fluids and caffeine for about 4 hours before, so the medicine is not too diluted.
- Do not take a water pill (diuretic) that morning unless told to — ask if you are unsure.
- Empty your bladder just before the treatment.
The day of
Your care team places a thin catheter and puts the medicine into your bladder, then removes the catheter. You hold the medicine in your bladder for the time you are told — often about 2 hours — and may be asked to change positions so it reaches all of the bladder. Then you urinate it out.
The first few days
Bathroom safety for about 6 hours after each treatment
- Sit down to urinate to avoid splashing.
- After you urinate, pour about a cup of household bleach into the toilet.
- Let it sit for 15 to 20 minutes, then flush.
- Wash your hands and the genital area well.
This protects the people around you from the live medicine.
How you may feel
- Burning, urgency, and frequent urination for a day or so
- A small amount of blood in the urine
- Mild flu-like feeling — low energy or aches — for about a day
After the holding period is over, drink extra water to flush the bladder. Symptoms usually ease within a day or two after each treatment.
The first few weeks
Treatments are usually given once a week for a course of several weeks, sometimes with more treatments later. It is common for the bladder symptoms to build up a bit over the course. Tell your care team how you are tolerating it.
When to call your care team
Call the office number on your discharge paperwork right away, or seek emergency care, if you have any of these:
- A fever of 101°F or higher, shaking chills, joint aches, or a rash — these can be signs of a reaction to BCG and need prompt care
- Severe or lasting burning beyond a day or two
- Heavy bleeding or blood clots in the urine
- You cannot urinate at all
If you have chest pain, trouble breathing, fainting, or another life-threatening emergency, call 911.
MyUrologyCare — BCG / Intravesical TherapyRead or reprint this guide at: myurologycare.org/procedures/bcg-therapy.html
Educational only — not medical advice and not a substitute for your care team. Follow your own discharge instructions. Call the office number on your discharge paperwork with questions. For an emergency, call 911.