Patient education: Bladder instillation (The Basics)

What is bladder instillation? — Bladder instillation is when liquid medicine is given into the bladder. Doctors call this "intravesical therapy." It allows the medicine to coat the inside of the bladder. Most of the time, when a medicine is given this way, it only affects the bladder and not other parts of the body.

Doctors use bladder instillation of medicines to treat or prevent certain bladder problems. Examples include:

●Bladder cancer

●Bladder pain

●Bladder infections

●Bladder stones

You might need a bladder instillation once or multiple times. This depends on why you are getting them and the medicines used. Your doctor will talk with you about how often you need a bladder instillation.

How is a bladder instillation done? — Bladder instillation is done through a "urinary catheter." A catheter is placed in the "urethra," the tube that carries urine from the bladder out of the body (figure 1).

In some cases, bladder instillation is done in a doctor's office or clinic. In other cases, people do bladder instillation at home. This article is about bladder instillations that are done by a doctor or nurse.

How do I prepare for bladder instillation? — The doctor or nurse will tell you if you need to do anything special to prepare. Before your procedure, your doctor might do an exam.

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

If you usually take a diuretic, ask if you should take it on the day of instillation. They might want you to wait to take it until after the instillation.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

●Any surgeries you had on your bladder, kidneys, urethra, or ureters

●Any symptoms of a bladder or kidney infection – These include blood in your urine, a fever, or needing to urinate frequently.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during bladder instillation? — When it is time for the procedure:

●The staff will place a urinary catheter and drain any urine from your bladder.

●The doctor will put a mixture of fluid and medicine through the catheter into your bladder. In some cases, heat or an electrical current is used. This can help your body absorb the medicine.

●You will hold the fluid and medicine in your bladder for a time. This could be anywhere from a few minutes to a few hours. The doctor will tell you how long you need to hold the fluid in your bladder for the medicine to work. They might also have you change positions. This helps coat all of your bladder with the fluid and medicine.

●In some cases, the doctor will drain the fluid from your bladder using the same catheter. In other cases, they will remove the catheter. Then, you will sit on the toilet to urinate. This keeps the urine and fluid mixture from splashing onto your skin.

What happens after bladder instillation? — Most people can go home after bladder instillation. Make sure that you know what problems to look out for and when you should call the doctor. Ask questions about anything you do not understand.

After a bladder instillation, the doctor or nurse will tell you if you need to take extra care with your urine. This depends on the medicine you got. Most of this advice is for people who are being treated for bladder cancer.

You might need to:

●Continue to sit down when you urinate for a few hours or the rest of the day.

●Use a separate toilet from other people.

●Pour bleach into the toilet after urinating.

●Flush the toilet 2 times after urinating.

Your doctor might also tell you to:

●Drink extra fluids after bladder instillation.

●Wash your skin after you urinate. This helps keep your skin from getting irritated by the medicines.

●Wash your clothes separately from other people's clothes if there is urine on them.

●Use a condom during sex until your treatment is completed.

What follow-up care do I need? — Your doctor or nurse will tell you if you need to make a follow-up appointment. If so, make sure that you know when and where to go.

What are the risks of bladder instillation? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Bladder or belly pain

●Bladder irritation, or a burning feeling in your bladder

●Infection or urinary tract infection

●Blood in your urine

●Needing to urinate more than normal

Bladder instillations done for cancer can have more risks than those done for other reasons. Possible additional risks include:

●Skin rash

●Your bladder holding less urine after treatment

●Fever

●Body aches

When should I call the doctor? — Call for advice if:

●You have signs of a urinary tract infection. These might include:

•Pain or burning feeling when you urinate

•The need to urinate more often or with more urgency than usual

•Blood in your urine

•Fever of 100.4°F (38°C) or higher

●You cannot urinate for more than 8 hours.

●You have a new skin rash.

●You have new pain in your joints.

●Your stomach is very upset, or you are vomiting a lot.

More on this topic

Patient education: How to use a catheter to empty the bladder (The Basics)
Patient education: Urinary catheter placement (The Basics)
Patient education: How to care for a urinary catheter (The Basics)
Patient education: How to remove a urinary catheter (The Basics)
Patient education: Lowering the risk of a catheter-associated urinary tract infection (The Basics)
Patient education: Bladder cancer (The Basics)
Patient education: Bladder pain syndrome (interstitial cystitis) (The Basics)
Patient education: Blood in the urine (hematuria) in adults (The Basics)
Patient education: Blood in the urine (hematuria) in children (The Basics)

Patient education: Bladder cancer treatment; muscle invasive cancer (Beyond the Basics)
Patient education: Treatment of interstitial cystitis/bladder pain syndrome (Beyond the Basics)
Patient education: Blood in the urine (hematuria) in adults (Beyond the Basics)
Patient education: Blood in the urine (hematuria) in children (Beyond the Basics)