What is intravesical bladder instillation therapy
Intravesical bladder installations therapy refers to instillation of medications inside the bladder. A number of medications may be instilled inside the bladder for various reasons. Anticholinergic medications can be administered in the bladder for overactive bladder treatment. Various combinations of medications with anesthetic properties (DMSO) can be used for treating patients with interstitial cystitis and painful bladder syndrome.
Chemotherapeutic medications (chemotherapy) and immunotherapy medications can be instilled in the bladder for treatment of superficial bladder cancer.
Intravesical bladder therapy is administered by inserting a urethral catheter in the bladder and the instilling medications through the catheter. The catheter is then removed and the medication is allowed to dwell in the bladder. After the medication escape and the bladder fully recommended period of time the bladder is emptied through urination.
Treatment of superficial bladder cancer( Ta CIS and T1) with intravesical therapy.
Mitomycin-C which is a chemotherapeutic medication and BCG which is an immunotherapy medication are commonly used for treatment of superficial bladder cancer.
BCG treatment
BCG (bacillus Calmette Guerin) is a weakened strain of live tuberculosis bacteria. It has been shown to be very effective for prevention of recurrent bladder cancer. It is slow to modulate the immune system within the bladder to attack and destroy bladder cancer cells.
BCG is used for carcinoma in situ (CIS) of the bladder as well as recurrent Ta, high-grade Ta and T1 bladder tumours. It is also used for upper tract transitional cell carcinoma tumors of the ureters and the kidney.
BCG is administered as induction therapy once weekly for 6 weeks typically 3-4 weeks after bladder tumor resection. Following that, maintenance therapy once weekly for 3 weeks every 3-6 months is given for 3 years. Maintenance therapy has been shown to decrease bladder cancer recurrence and is suggested to improve survival in patients with bladder cancer.
Because BCG is a life attenuated bacteria it can occasionally cause active infection in some patients. Patients who are immunocompromised, taking steroids or other medications that suppressing the immune system are not good candidate for BCG.