Urology Casablanca

BCG intravesical insilLations

Analysis of the polyp that was removed from your bladder has detected malignant, superficial cells, which requires further treatment. In order to make an informed decision, you must be informed of the normally foreseeable consequences and the risks associated with the treatment. Your doctor will explain to you, in an interview, why additional treatment is necessary, its principle and its procedure. The bladder The bladder is the reservoir in which urine from the kidneys is stored before being evacuated during urination. Its inner wall is covered with a mucous membrane. It is this mucous membrane that gave rise to the recently removed polyp. Legend: pr: prostate; r: rectum; u: ureter; ur: urethra; ut: uterus; va: vagina; ve: bladder.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Why this treatment? Analysis of the polyp detected malignant, superficial cells. The risk of this condition is to recur and in some cases progress to deeper planes of the bladder wall. To limit these risks, additional treatment to endoscopic resection is recommended, involving intravesical instillations of Calmette-Guérin bacilli (BCG). The principle is not that of a vaccine. This treatment works through an attenuated strain of mycobacteria, the effect of which is to trigger a local inflammatory and immune reaction aimed at preventing a new tumor from developing and, in some cases, suppressing certain flat tumors. This treatment has been used since 1976. Are there other possibilities? Other products can be instilled, better tolerated but often less effective in your case. Removal of the bladder could be considered, but only in the event of failure of the conservative treatment undertaken. This is why it is very important that you undergo the checks that will be indicated to you by the team that has taken charge of your treatment.

Treatment procedures It consists of performing several instillations of BCG in the bladder, the number and frequency of which will be specified to you by your urologist. The treatment must be started at least fifteen days after the endoscopic resection of the bladder, when there is no more urinary bleeding, and after checking the absence of urinary infection before each instillation. Each instillation consists of injecting the product into the bladder via a probe introduced through the urethra. It is recommended to reduce the drinks during the two to three hours preceding the instillation; you are asked to keep the product in the bladder without urinating for a minimum of one hour and, at best, two hours. At the end of this period, you will have to urinate while sitting on a toilet which will be cleaned with undiluted bleach and drink plenty of water for approximately 48 hours. Usual suites This treatment can make you tired, be responsible for a burning sensation in your bladder and a transient fever, sometimes linked to a urinary tract infection. It is preferable, as long as the side effects persist, to avoid exertion, travel and sexual intercourse, and to postpone the next instillation. Certain drugs can alter the effect of BCG and its effectiveness. This is why your doctors should be kept informed of any medications you are taking while on this treatment. It is very important that you submit to the subsequent checks that will be indicated to you by the team that has taken charge of your treatment.

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Risks and Complications Certain events must make you consult without delay: fever higher than 38°5, persistence beyond 48 hours of symptoms such as: fever, blood in the urine, malaise. Complications of this treatment are rare: infection of the genital organs in men, allergy. Exceptionally may occur: retraction of the bladder, infection of the kidney, liver, lungs, joint. Your urologist is at your disposal for any information.