Is the bladder instillation process painful?

Bladder instillation is a relatively common treatment method, and it is also a popular treatment method now. After the treatment, patients need to pay attention to care in their daily lives, so as to prevent bigger problems from occurring in their bodies. It is mainly used in some high-risk patients. For example, patients who need chemotherapy are usually treated with bladder instillation.

Non-muscle-invasive bladder tumors (Ta-T1) should undergo transurethral resection of bladder tumors (TUR-BT), followed by postoperative intravesical chemotherapy. There are many perfusion schemes, the most commonly used one is once a week after surgery for a total of 8 times, then once a month for a total of 10 times, continuing for one year. The main perfusion drugs include epirubicin, mitomycin, pirarubicin, doxorubicin, hydroxycamptothecin, etc., and the effects are basically the same. Bacillus Calmette-Guérin (BCG) instillation has the best effect, but it may cause severe irritation symptoms, bladder contracture, tuberculosis dissemination, etc. It is rarely used clinically and is suitable for high-risk bladder cancer patients.

Muscle-invasive bladder tumors should be treated with radical cystectomy and pelvic lymph node dissection. This surgery is the standard treatment for muscle-invasive bladder cancer and is an effective treatment for improving the survival rate of patients with invasive bladder cancer and avoiding local recurrence and distant metastasis. Radical cystectomy can also be performed for high-risk non-muscle invasive bladder cancer T1G3 tumors, carcinoma in situ that is refractory to BCG treatment, recurrent non-muscle invasive bladder cancer, and extensive papillary lesions that cannot be controlled by TUR or endoscopic surgery alone.

For patients with invasive bladder cancer who are physically unable to tolerate radical cystectomy or who are unwilling to undergo radical cystectomy, comprehensive bladder-preserving treatment can be considered.

Advanced bladder tumors can be treated with adjuvant chemotherapy or radiotherapy, with the GC regimen being the main chemotherapy regimen.

Non-urothelial bladder cancer

1. Squamous cell carcinoma

Patients with simple squamous cell carcinoma of the bladder should choose radical cystectomy. Preoperative radiotherapy for high-grade and high-stage tumors can help prevent pelvic recurrence. In the absence of effective chemotherapy drugs, radiotherapy can be chosen before radical surgery.

(ii) Adenocarcinoma

Bladder adenocarcinoma can be divided into three types according to its tissue origin: primary non-urachal adenocarcinoma, urachal adenocarcinoma, and metastatic adenocarcinoma.

1. Non-urachal adenocarcinoma: Most cases are already in the locally advanced stage when they are clinically diagnosed, and radical cystectomy is recommended to improve the efficacy. Chemotherapy can be considered for advanced and metastatic adenocarcinoma.