Intravesical BCG

What is BCG?

Bacillus Calmette-Guerin (BCG) is a weakened bacterium given in the bladder. It activates the immune system to reduce the risk of bladder cancer recurrence.

Why do you need

Intravesical BCG?

You have been diagnosed with bladder cancer which has high risk for recurrence.

BCG is given once a week as an induction course for 6 weeks, followed by a maintenance course thereafter. Before starting and during the maintenance course of BCG, cystoscopy will be performed at regular intervals to look for tumour recurrence. The optimal number of maintenance courses will be determined by the ordering doctor.

How is the procedure performed?

BCG is administered directly into the bladder through a urinary catheter.

If a urine infection is present, BCG administration will be postponed until the urine infection is adequately treated.

You should hold the medication for 2 hours before passing urine. Please inform the nursing staff before you pass urine as the medication has to be disposed in a designated toilet.

Are there any risks involved? You may experience symptoms such as:

• Increased urgency

• Increased frequency

• Burning pain

• Blood in urine

Rarely, BCG can be absorbed into the body, leading to a serious infection, which will require admission for treatment.

Post-procedure advice

You will be able to travel home and continue your activities after the treatment.

A nurse will call you on the next working day to check on your symptoms.

Treatment Schedule

1st - 6th week

Weekly BCG induction

3rd month Cystoscopy 

Weekly BCG maintenance for 3 weeks

6th month Cystoscopy 

Weekly BCG maintenance for 3 weeks

12th month Cystoscopy 

Weekly BCG maintenance for 3 weeks

18th month Cystoscopy 

Weekly BCG maintenance for 3 weeks

24th month Cystoscopy 

Weekly BCG maintenance for 3 weeks

30th month

36th month

Cystoscopy 

Weekly BCG maintenance for 3 weeks

Cystoscopy 

Weekly BCG maintenance for 3 weeks

Preparation for intravesical BCG

• Stop drinking fluids at least 2 hours prior to the scheduled procedure

• Please inform the clinic if you are experiencing any of the following symptoms, which may make you unsuitable to proceed with the procedure and require postponement

» Fever and/or chills

» Blood in the urine

» Pain and/or burning sensation on passing urine

» New onset of urinary frequency and/or urgency

» Difficulty passing urine

Day of intravesical BCG

• Please allow at least 4 hours for the procedure

• Please be punctual for your appointment

• Remember to empty your bladder before starting treatment

When to seek medical attention:

• High fevers (≥38°C)

• Persistent chills

• Blood clots in urine

• Difficulty passing urine

Medical advice

Please contact our Customer Contact Centre at 6555 8828 for an urgent appointment to return to the Urology Clinic during Office Hours. For any emergency after office hours, please proceed to the KTPH Acute and Emergency Department (A&E).

Yishun Health is a network of medical institutions and health facilities of the National Healthcare Group in the north of Singapore. It comprises Khoo Teck Puat Hospital, Yishun Community Hospital and community extensions such as Admiralty Medical Centre and Wellness Kampung.

Khoo Teck Puat Hospital • (65) 6555 8000 • www.ktph.com.sg

Yishun Community Hospital • (65) 6807 8800 • www.yishuncommunityhospital.com.sg

The information is correct at the time of printing and subject to revision without further notice.

URO.PE.16.0124