Intravesical bladder treatment is a minimally invasive, relatively painless procedure that deposits medication directly into the bladder. It is an effective treatment for the early stages of bladder cancer and is also used to alleviate symptoms of interstitial cystitis. Intravesical therapy is typically administered several times over the course of several weeks.

Bladder Cancer

Intravesical bladder treatment delivers chemotherapy or other medications directly into the bladder. It is used only for the early stages of cancer as advanced stages penetrate too deep into the bladder wall for intravesical therapy to be effective. According to The American Cancer Society, the Bacillus Calmette-Guerin (BCG) protocol, for intravesical therapy, which uses live tuberculosis vaccine, is the most effective against bladder cancer. Patients will be asked to avoid urination for several hours in order to keep medication in the bladder as long as possible.

Interstitial Cystitis

Interstitial Cystitis is a chronic condition characterized by frequent urination and pain. Intravesical therapy provides relief of symptoms while avoiding the side effects of oral medication. Dimethyl sulfoxide (Rimso-50) is the only FDA approved medication for intravesical therapy in cases of interstitial cystitis. However, other medications or protocols may be used, including heparin, which is sometimes added to extend the results of the treatment. The Journal of Urology reports a 60% improvement in symptoms when using the Bacillus Calmette-Guerin protocol for interstitial cystitis.

Baccillus Calmette-Guerin (BCG) Protocol

The Baccillus Calmette-Guerin (BCG) protocol is the most effective intravesical therapy for cancer and interstitial cystitis as determined by the Cochrane Review and the American Cancer Society. It uses a live, but weakened, tuberculosis vaccine, which does carry a small risk of infection. Patients will have to take extra precautions after treatment to avoid contaminating common surfaces with the live tuberculosis germs. Common precautions include using the same toilet, disinfecting the toilet with bleach and the use of condoms during and after treatment.


Intravesical therapy does not require anesthesia, but numbing agents are used to thread a catheter through the urethra into the bladder. Patients should follow their physician's directions closely, but, in general, patients are advised to avoid drinking several hours before as well as after the procedure. Patients may need a pad to catch any leakage, but can return to regular activities once the intravesical therapy is completed.

Side Effects

Side effects last between 3 to 5 days and vary with the type of medication used. The most common side effects are similar to a urinary tract infection in sensation including bladder irritation and burning during urination. Additional side effects are; frequent urination, bladder spasms, discomfort, and blood in the urine. If a fever develops after intravesical therapy, patients should consult with their doctor. For fevers of 101 degrees and up, patients may need to seek emergency care.

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