What is BCG treatment?

BCG is a live vaccine used to vaccinate against TB (tuberculosis) but is also used to treat bladder. It can be put into the bladder through a catheter to help reduce the risk of cancer coming back or recurring. When it is put into your bladder it causes inflammation, which then destroys cancerous cells. BCG is given once a week for 6 weeks.

Reasons for not having BCG

  • If you have a Urinary tract infection (UTI)
  • If you have Immunosuppressive medication or are immunocompromised
  • If you have a bleeding disorder
  • If you have active TB and are receiving treatment
  • If you are breastfeeding, pregnant or trying to conceive

Is there anything I need to do before my treatment?

  • A urine sample will be sent for testing before you commence your first treatment to make sure you do not have an infection in your bladder.
  • Geelong Urology will organise for your medication to be available from the Geelong Hospital Pharmacy on the day of your first treatment and then again on the day of the fourth treatment (you can only pick up 3 lots of the medication at one time).
  • You need to go to Geelong Hospital Pharmacy to collect your treatment. THe pharmacy will give you three vials of medication and you must bring the medication and you must bring this immediately to the rooms so they can be stored in our drug fridge.
  • You should not drink fluids for 4 hours before treatment. You can eat normally. By drinking less your kidneys will produce less urine. This will help prevent the BCG bring diluted and will also make it easier for you to hold the BCG in the bladder.
  • If you take water tablets (diuretics) either take them after the BCG treatment or 6 hours before your treatment. THis will reduce the amount of urine produced and will enable you to hold the BCG in your bladder.

What happens during treatment?

  • You will be asked to pass urine so that your bladder is empty.
  • A catheter will be passed into the bladder through the urethra to drain any remaining urine. BCG is mixed in a little water, and put into the bladder through the catheter.
  • The catheter will then be removed.
  • You will be asked not to pass urine for the next 2 hours. It is during this time that the treatment is working to destroy the cancer cells.
  • We encourage you to walk about the bladder. If you cannot, please lie down and turn from back to side and front every 15 minutes to ensure the BCG covers the whole bladder.
  • You will need to keep the BCG in your bladder for 1-2 hours. Once the treatment is in, you should feel well enough to drive yourself home after the treatment.

What happens after treatment?

  • When the BCG has been in the bladder for 2 hours please pass the urine in the toilet. Men please sit rather than stand to pass urine to prevent urine splashing.
  • Pour 2 cups of undiluted bleach into the toilet and let it stand for 15 minutes before flushing. Ensure no one uses the toilet and let it stand for 15 minutes before flushing. Ensure no one uses the toilet during this time or before flushing. All urine passes within 6 hours from the initial time your treatment was given, should be treated as above.
  • Abstain from intercourse and oral sex for 2-3 days after each treatment. The use of condoms for several weeks after completion of treatment is recommended.
  • You are able to carry out normal activities after treatment with no restrictions on work or driving
  • Wash hands/genital area with soap and water each time after passing urine. Thiis should be done for 6 hours after treatment.

Are there any possible side effects from the treatment?

  • 9 out of 10 people having BCG treatment will develop some side effects: these usually begin within 3-4 hours after treatment and may last 1-3 days.
  • Pain and/or burning when passing urine
  • Blood in your urine
  • Needing the pass urine frequently
  • Fever, flu like illness or generally feeling unwell
  • Drinking 2L of fluid, unless advised otherwise and avoiding tea/coffee for 24 hours after treatment will help flush any remaining drug out of the bladder and ease the above symptoms.
  • These symptoms usually last for 1-2 days.

Contact Geelong Urology if:

  • Symptoms persist for more than 2-3 days
  • Urine is cloudly/offensive smelling
  • Fevers/Temperature >38
  • Vomiting
  • Joint pain
  • Skin rash
  • Cough

See a doctor or attend Emergency if you develop Shortness of breath, difficulty breathing or facial swelling. And you need to inform them you have had BCG treatment.


After you have completed your treatment you need to repeat a cystoscopy in 4-6 weeks time to ensure the treatment has worked. This is normally under a general anaesthetic and further biopsies will be taken at this time.

Do we give BCG injections pre travel?

Please be aware that the BCG we give is into the bladder as a treatment for cancer. It is not the Tuberculosis needle required for pre travel overseas.