Intravesical chemotherapy for bladder cancer

Bladder cancer is one of the common malignant tumors of the urinary system. 80% of patients will relapse after bladder preservation surgery. Intravesical instillation of chemotherapy drugs is the safest and most effective method to prevent and treat bladder cancer recurrence. Choosing effective instillation drugs and implementing correct instillation methods play a vital role in the prevention of bladder cancer after surgery.

The night before bladder instillation, patients should ensure adequate sleep and clean the vulva. Drinking water is prohibited for 6 hours before instillation to reduce urine output and drug absorption. Empty the bladder before instillation to avoid excessive residual urine. During instillation, the chemotherapy drug is dissolved in 40 ml of normal saline and instilled into the bladder through a catheter. After instillation, help the patient change position once every half an hour, that is, supine position, left side position, prone position, and right side position for half an hour each, so that the drug solution can fully contact the bladder mucosa and take effect. After 2 hours, the drug solution can be excreted by itself. Advise the patient to drink more water to increase urine output, which plays a role of natural flushing, reduces the drug concentration in the excreted urine, and reduces the drug irritation to the urethral mucosa.

Currently, commonly used intravenous chemotherapy drugs include mitomycin, pirarubicin, BCG, etc. Common adverse reactions to intravenous chemotherapy include fever, bladder irritation symptoms, and urethral stenosis. Intravesical instillation chemotherapy is performed once a week for a total of 8 times. Within 2 years after treatment, cystoscopy is performed every 3 months, and after 2 years, cystoscopy is performed every 6 months.