Administering Intravesical Therapies and Dosing Schedules

This segment compares the practical logistics of delivering intravesical therapies and encourages clinics to identify treatment champions among pharmacy, clinic, and provider staff. For reverse thermal mitomycin gel, pharmacy staff reconstitute and chill the drug, which is then instilled by Foley catheter. The patient rests briefly before the catheter is removed and goes home. Bacillus Calmette-Guérin (BCG) requires patients to hold the medication in the bladder for a longer period, though practices differ on catheter management. Gemcitabine and docetaxel are instilled one after the other, each with its own dwell time. On dosing, the faculty explain that the gel involves a weekly induction course without maintenance. BCG and gemcitabine plus docetaxel both add maintenance after induction, with the BCG maintenance schedule based on a SWOG trial. Cystoscopy follows induction to assess response. Before treatment, the team confirms the bladder is intact and rules out active urinary tract infection, and some regimens also require lab and pregnancy monitoring.