Intravesical Therapy

What is intravesical therapy?

Intravesical (also called intravesicular) therapy is when medication is given into the bladder. The bladder (vesical) is between your pelvis and hips and stores your urine. Intravesical therapy can be used to treat some types of early stage bladder cancer.

Either an immunotherapy or chemotherapy medication is used. 

The most common immunotherapy medicine used is bacillus calmette-guerin (BCG, TICE®, TheraCys®). Nadofaragene firadenovec-vncg (Adstiladrin®) and nogapendekin alfa inbakicept-pmln (Anktiva®) are other medicines that may be given. 

The chemotherapy medications used are gemcitabine (Gemzar®), mitomycin (Mutamycin, Mitomycin-C), epirubicin (Ellence®, Pharmorubicin®) and docetaxel (Taxotere). 

When is intravesical therapy used?

These therapies are given when cancer cells in the bladder's lining have not grown into the inner layers. This is because when intravesical therapy is put into the bladder it is most effective in treating the bladder lining.

How are intravesical therapies given?

The medication is given through a catheter (a thin tube). The tube is placed into your urethra and then ends in your bladder. The medication is given through the catheter and into your bladder.  You will have to hold the medication in your bladder, often for 1 to 2 hours so that the medication has time to work.

It can be done after you have had surgery to remove a tumor or in an outpatient clinic setting. Your providers will talk to you about when you will receive the medication and how often.

What steps should you take while you are getting intravesical therapy?

After you are given the medication, it will come out with your urine (pee) for the next few days. There are some things you may need to do for the few days after treatment:

• Your provider may tell you not to have sex for some time after having intravesical therapy. This is to protect your partner from the medication that was put in your bladder. You should also use protection such as a condom.
• It is important to stay hydrated after treatment. This can help lessen side effects.
• Practice hand hygiene (washing your hands).
• Clean your genital area with water and/or soap after urinating (peeing).
• You may be told to sit down while urinating to avoid splashes, wipe down the toilet bowl after use, or use a different toilet from those you live with. This is to protect them from any chemotherapy.

Your provider will tell you more about what you should and should not do after treatment.

What are the side effects?

Intravesical therapy is a localized treatment. This means it affects the bladder rather than the whole body like an intravenous (IV) medication would do. Some of the common side effects that have to do with the bladder are:

• A burning feeling when urinating.
• Seeing blood in your urine.
• Feeling the need to urinate more often.

You may have other side effects depending on the medication used. Tell your care team about any side effects you are having.  

Intravesical therapy may be a treatment option for some patients. Ask your provider any questions you might have about this treatment.