Instillation treatment (irrigation) for superficial bladder cancer

Most bladder tumours are superficial. As long as this condition is met, no total bladder removal needs to be considered. Nevertheless, it is known that superficial bladder tumours can occur again and again, and thus there are therapies to reduce their occurrence. Since the bladder surface is directly accessible through the urethra, any substances can be brought directly to their destination and general side effects can be largely avoided.

 

Basically, this works in such a way that the patient comes to the clinic on an outpatient basis. A bladder catheter is placed and the corresponding therapeutic solution fluid is introduced into the bladder through the catheter. The catheter is then removed and the patient can leave the clinic fifteen minutes later. The appropriate fluid should be kept in the bladder for as much as 1-2 hours before the patient evacuates his bladder naturally.

 

Instillation prophylaxis with epirubicin/mitomycin

This is a classic chemotherapeutic agent. But because the preparation does not penetrate the whole body through the veins and can even attack at high concentration in the bladder exactly at the site of action, there are no typical chemotherapy side effects such as hair loss, nausea, etc. Such a cycle lasts 6 - 12 weeks, with the instillations usually being done once a week.

Instillation prophylaxis with BCG

BCG is a strain of an attenuated tuberculosis bacterium. The exact mechanism of action has not been fully explored until today. It is agreed that this is a kind of immune response of the body. These bacteria lead to >intended biliary cystitis. In the course of these cystitis, however, the tumour is combated. However, typical cystitis symptoms and often flu symptoms with fever and joint pain occur regularly. BCG therapy is discontinued prematurely in a quarter of patients, as the side effects become too stressful for the patient.

There are different instillation cycles from 6 cycles of 1x per week to cycle schemes, which last up to 1 year. Especially in more aggressive but superficial bladder tumours, this therapy is very efficient and also established worldwide.

Your doctor will discuss with you whether instillation therapy is appropriate and in what form.

Do you have any questions?

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