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Urological Surgeons

BCG Treatment

To download a PDF document about ‘BCG treatment’ please click:

  • Intravesical treatment is a treatment where a drug is placed directly into the bladder.
  • BCG (Bacillus Calmette-Guerin) is normally used as a vaccination to protect against tuberculosis. When placed in the bladder it is thought to provoke an immune response. This helps to rid the bladder of tumour and reduce the chance of it coming back.
  • The drug is prepared as a liquid (approximately ¼ cup) then instilled into your bladder with a catheter. It is retained for 2 hours then voided out normally. This usually involves an instillation weekly for 6 weeks.
  • A urine sample will be sent for testing before you commence your first treatment to make sure you do not have an infection in your bladder.
  • The Urology Nurse will organise for your medication to be available from the St John of God Hospital Pharmacy on the day of your first treatment and then again on the day of your fourth treatment (you can only pick up 3 doses of the medication at one time). Payment will need to be reconciled upon pick up of the medication.
  • On the day of your treatment please limit your fluid intake for 4 hours beforehand. This reduces the amount of urine in your bladder so the treatment is more effective.
  • You need to go to St John of God Hospital Pharmacy on the day of your first and fourth treatment to collect your medication. The pharmacy will give you 3 vials of the medication plus the equipment required in an ‘eskie or cold bag’ and you must bring this immediately to the rooms so they can be stored in our drug fridge. On the other treatment days you can come straight to the rooms as we will already have the medication here.
  • When you arrive at the rooms the nurse will ask you to empty your bladder. Please tell the nurse if you have had any change in your urinary symptoms recently eg pain, burning or blood in the urine.
  • The nurse will pass a catheter into your bladder and drain any urine left after you have emptied your bladder.
  • The drug is slowly instilled into your bladder via the catheter.
  • The catheter is removed and you will be asked to hold the medication in your bladder for up to 2 hours, or as long as you can.
  • If you feel well and are able to hold the medication in your bladder you can go home. For your first treatment you will need to have someone to drive you home afterwards in case you have any adverse reaction to the treatment.
  • After two hours you need to empty your bladder. You should sit down to pass urine for the next 6 hours to prevent splashing, as the drug can cause a rash or skin irritation.
  • Once you have passed urine you need to put 1 cup of household bleach down the toilet and leave it for 15 minutes before flushing. This needs to be done each time you pass urine for the next 6 hours.
  • Make sure you wash your hands well each time you pass urine. If any urine splashes onto your skin, wash immediately with soap and water.
  • Once you have passed urine for the first time, you need to drink plenty of fluids for the next 6 hours to help flush the medication out of your bladder.
  • During the course of your treatment and for six weeks after your last dose, you should use a condom when you have sex with your partner.
  • Up to 6 weeks after completing the course of BCG a further cystoscopy (look inside the bladder) will be organised to see how successful the treatment has been. Biopsies may be taken.

You may notice some side effects after the treatment which may begin 2-4 hours after and can last for 1-2 days. This may include:

  • bladder spasms or cramps
  • burning or difficulty passing urine
  • blood in the urine
  • mild flu-like symptoms
  • frequency or urgency passing urine


These side effects may not be evident until after your second or third treatment and may increase as your treatment course continues.

You can take Paracetamol to help with general symptoms, or Ural sachets for urinary symptoms.

You must contact your surgeon if you have any concerns in regard to your treatment or if any of the following symptoms occur:

  • blood in the urine, painful or frequent urination lasting more than 2 days
  • fever (greater than 38.5°) and chills
  • nausea and vomiting
  • increased or new cough
  • skin rash
  • joint pain


Please do not hesitate to contact our Specialist Urology Nurses on 5229 8550 in office hours if you have any questions or concerns in regard to this treatment.