intravesikale

Intravesikale, or intravesical, refers to administration within the urinary bladder. In medical practice it describes the instillation of a therapeutic agent directly into the bladder through a catheter, allowing prolonged contact with the bladder mucosa while limiting systemic exposure.

The most common use is in the treatment and prevention of non-muscle invasive bladder cancer (NMIBC). Agents such as Bacillus Calmette-Guérin (BCG) and various chemotherapeutic drugs (for example mitomycin C, gemcitabine, or doxorubicin) are instilled after transurethral resection of bladder tumor (TURBT) to reduce tumor recurrence and, in some regimens, progression. Intravesical therapy is often given in a series of sessions over weeks to months and may require maintenance schedules.

Intravesical therapy is also used for non-oncologic bladder conditions in some cases, including certain types of interstitial cystitis, radiation or chemical cystitis, or prophylaxis after bladder procedures. These regimens vary in drug choice, concentration, and dwell time, but share the principle of local mucosal treatment with minimal systemic absorption.

Administration typically occurs on an outpatient basis. A sterile catheter is inserted to instill the drug, which is then left in the bladder for a specified dwell time (commonly around 1–2 hours) before the fluid is emptied. Patients are advised to avoid voiding during the dwell period and to maintain privacy and comfort. For certain agents such as BCG, precautions may be advised to reduce exposure risk to others.

Adverse effects are mainly local, including urinary frequency, dysuria, and irritative symptoms. Systemic reactions are possible with some agents and, in the case of BCG, there is a risk of infection or immune-related effects. Proper aseptic technique and patient selection are essential.