See the ABC UK Patient Decision Aid for High Risk NMIBC:
ABCUK PATIENT DECISION AID JAN 2022.pdf
You will be asked to pass urine to make sure the bladder is empty.
You will then have a tube (catheter) put in the urethra. The BCG is a liquid and will pass through this tube directly into the bladder.
The catheter is then usually removed. Sometimes it may be left in and clamped. You shouldn't pass urine for 2 hours. You can walk about whilst the BCG is in your bladder. When you do pass urine, you will need to be careful for 6 hours after the treatment as the vaccine contains live TB.
The treatment session will take a little over 2 hours after which you will be able to go home. You should feel well enough to drive yourself home after the treatment.
After your first few treatments, if you live within easy reach of the hospital and have your own transport, you may be allowed to go home with the medication in your bladder and pass urine at home after two hours.
If you are elderly or have mobility issues, you may wish to arrange for a friend or relative to accompany/collect you. You will be able to carry out your normal activities after treatment. There are no restrictions on driving, work etc.
If the catheter was left in the bladder during your treatment, the BCG will be drained back into a bag before the catheter is removed.
If you would like something to drink you can now do so.
Sex - you should abstain from intercourse/oral sex for 2-3 days after each treatment. The use of condoms thereafter is advised and should continue to be used for several weeks after your treatment has been completed.
Pregnancy - the effects on pregnancy are unknown. If you are planning to have children you should discuss this with your doctor as female patients of child bearing age are advised to use birth control during treatments and to wait at least 2 years before conceiving, longer if on maintenance treatment.
Breast feeding is not advised when having BCG treatment
All the urine you pass during the first 6 hours after treatment should be treated as contaminated. After you have passed urine, it is recommended that you pour 2 cups of household bleach into the toilet and leave this for 15 minutes before flushing. Ensure no one uses the toilet during the 15 minutes or before flushing. Bleach neutralises the live BCG TB vaccine and you should continue to do this for 6 hours after treatment.
Wash hands/genital area with soap and water each time after passing urine for 6 hours after your treatment.
9 out of 10 people having BCG will develop some side effects; these usually begin within 3-4 hours after treatment and may last 1-3 days.
Common treatment effects
You should tell your doctor at your next appointment if you have any of these symptoms.
Drinking 2 litres of fluid daily, unless advised otherwise, and avoiding tea/coffee for 24 hours after treatment will help flush any remaining drug out of the bladder and may ease the above symptoms.
Occasional
Rare
Very rarely - less than 1 person in every 100 - may experience more serious treatment effects.
Contact your GP/Nurse immediately if you have any of the following:
See a doctor or attend A&E immediately if you develop:-
Shortness of breath
Difficulty breathing
Facial swelling
You need to inform them that you have had BCG treatment
Your doctor may decide to continue with maintenance therapy to reduce the risk of bladder cancer recurring. This involves having BCG once a week for 3 weeks at 3, 6, 12, 18, 24, 30 and 36 months following your first treatment.
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