What is Intravesical Treatment?
Intravesical therapy is a treatment used for certain types of bladder cancer, particularly non–muscle invasive bladder cancer.
In this treatment, medication is placed directly into the bladder through a catheter. The medicine acts on the lining of the bladder to destroy cancer cells or reduce the risk of the cancer returning.
Because the medication is delivered directly into the bladder, it has limited effects on the rest of the body.
Intravesical Treatment for Bladder Cancer
Why is Intravesical Treatment Used?
Intravesical therapy is usually recommended after a procedure called Transurethral Resection of Bladder Tumour (TURBT).
The treatment aims to:
Destroy any remaining cancer cells
Reduce the risk of tumour recurrence
Prevent progression of bladder cancer
Not all bladder cancers require intravesical therapy. Your doctor will recommend it based on the type, grade, and stage of the tumour.
How is the Treatment Given?
Intravesical therapy is usually performed in a clinic or outpatient setting.
During the procedure:
A small catheter is inserted through the urethra into the bladder.
The medication is placed directly into the bladder through the catheter.
The catheter is removed.
You will be asked to hold the medication in the bladder for about 1–2 hours if possible.
After this time, you can pass urine normally.
Treatments are often given once a week for several weeks, depending on the treatment plan.
Types of Intravesical Treatment
The two main types of medication used are:
Intravesical Chemotherapy
Chemotherapy medicines placed into the bladder help kill cancer cells on the bladder lining.
Common medications include:
Mitomycin C
Epirubicin
Gemcitabine
This treatment is often given soon after TURBT or as a series of treatments to reduce recurrence.
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BCG Therapy (Bacillus Calmette-Guérin)
BCG is a form of immunotherapy. It uses a weakened form of bacteria to stimulate the body’s immune system to attack bladder cancer cells.
BCG is commonly used for:
High-risk non–muscle invasive bladder cancer
Carcinoma in situ (CIS)
Treatment is usually given weekly for several weeks, followed by maintenance therapy in some patients.
What to Expect After Treatment
Some temporary side effects are common and usually mild.
These may include:
Burning when passing urine
Increased urinary frequency
Urgency to urinate
Mild blood in the urine
Flu-like symptoms (more common with BCG)
Symptoms usually improve within a few days.
Drinking plenty of fluids may help reduce irritation.
Possible Risks and Side Effects
Although intravesical therapy is generally well tolerated, possible side effects include:
With Intravesical Chemotherapy
Bladder irritation
Urinary frequency or urgency
Skin irritation if the medication contacts the skin
With BCG Therapy
Fever or flu-like symptoms
Bladder inflammation (cystitis)
Rarely, more serious infection
Your healthcare team will provide instructions on how to manage these symptoms.
Safety Precautions After Treatment
For the first 6 hours after treatment, certain precautions may be recommended, especially after BCG therapy.
These may include:
Sitting down to urinate to prevent splashing
Washing hands and genital area after urinating
Cleaning the toilet with disinfectant or bleach after use
Your doctor or nurse will provide specific instructions.
Follow-Up and Monitoring
Bladder cancer requires regular follow-up, even after treatment.
Monitoring usually includes:
Regular cystoscopy examinations
Urine tests
Imaging studies when required
This follow-up helps detect any recurrence or progression early.
When to Seek Medical Attention
Contact your doctor if you develop:
Fever above 38°C
Severe pain or burning when urinating
Heavy bleeding in the urine
Difficulty passing urine
Persistent symptoms lasting more than a few days
These symptoms may require medical assessment.
