If you are having a course of BCG directly into your bladder (intravesical BCG), you have it in the hospital outpatient department. Your nurse or doctor will give you advice on preparing for your treatment. For example, they will ask you to limit the amount of fluids you drink 4 to 6 hours before BCG treatment. This can:

make it easier for you to keep the BCG in your bladder for the required time (stops you needing to pass urine (pee) too early)

increase the concentration of the BCG drug in your bladder.

People who take water tablets (diuretics) should take them after the treatment. Tell your doctor if you take any medications.

Before you have the BCG treatment, you are asked to lie down on a couch. A nurse passes a tube (catheter) through your urethra and into your bladder. The nurse then slowly puts the BCG directly into your bladder through the catheter.

During treatment

Once the drug is in your bladder, the nurse usually takes the catheter out. They ask you not to pass urine for 2 hours. This gives the BCG time to work.

You can get up and walk around while waiting for the treatment to finish. Your bladder may feel full and a bit uncomfortable. You can go to the toilet as soon as the treatment is finished.

Sometimes, the nurse leaves the catheter in and clamps it to keep the BCG in your bladder. When the treatment is over, the nurse removes the clamp and the BCG drains from your bladder into a urine bag. Your nurse can then take the catheter out.

After treatment

It is important to remember that BCG is a live vaccine and other people should not be exposed to it. The nurse will ask you to take certain precautions for 6 hours after treatment. This will protect you and others from coming into contact with the BCG.

You will be asked to:

sit down to pass urine – this avoids splashing urine on the toilet seat

wash the skin in and around your genital area with soap and water after you pass urine – this cleans any drops of BCG that may have splashed on to your skin

put undiluted bleach into the toilet bowl after you have passed urine and leave it for 15 minutes before flushing

wash your hands carefully after passing urine with soap and water.

For about 2 days after each treatment, you will usually be asked to drink at least 2 litres (3 ½ pints) of fluid a day. This helps to flush the drug out of your bladder.

Talk to your nurse if you are worried. They will tell you what you need to do after treatment.