When it comes to treating cancers, chemotherapies remain a popular option.

Chemotherapies involve putting strong drugs that stop cancer cells from reproducing, growing, and spreading into your body for a period of time.

Most chemotherapies are administered intravenously (into a vein) or orally with tablets. The type of chemotherapy someone might receive differs depending on the type of cancer, its severity, and a person’s overall health.

Intravesical chemotherapy is one such treatment, which involves putting chemotherapy drugs directly into the bladder using a catheter (a narrow, flexible tube) through the urethra, which transports urine out of the body.

Intravesical chemotherapy is almost always used to treat low-to-medium-risk, nonmuscle invasive bladder cancer. Such cancers have not spread into the deep layers of the bladder walls or other parts of the body. They grow fairly slowly.

Often, a doctor administers intravesical chemotherapy once following a surgery called transurethral resection of a bladder tumor (TURBT).

More recently, it’s been recommended for people who have recently undergone a nephroureterectomy (removal of the kidney and the tube that moves urine from the kidney into the bladder) after kidney cancer.

When intravesicular chemo is used after surgery in this instance, it’s used only to treat urothelial cancer of the renal pelvis, which is similar to bladder cancer.

Sometimes, intravesical chemotherapy is used to treat high risk (faster growing) noninvasive bladder cancers.

During an intravesical chemotherapy procedure, a catheter is inserted into the urethra and into your bladder. If you’ve recently had surgery to remove a bladder tumor, you probably already have a catheter inserted to collect draining urine — this tube will be used to administer intravesical chemotherapy.

Sometimes, the chemotherapy drugs are heated before being inserted into your body. After the drug has been inserted into your bladder via catheter, your catheter is usually removed by a doctor or nurse. You’re usually allowed to stand up or walk around during your treatment.

In other cases, the catheter might be left in, with its bag clamped. This keeps the chemotherapy in your bladder. If the catheter is left in during treatment, it will be removed after 1 hour.

It may feel like your bladder is very full following treatment. Your doctor or nurse will ask you not to pass urine for about 1 hour after treatment, so that the chemotherapy can work.

Recovery from intravesical chemotherapy differs from person to person. Usually, however, your doctor or nurse will advise you to take specific precautions for 6 hours after your treatment.

These recovery steps are meant to help protect you and other people from direct exposure to the chemotherapy drugs in your bladder. These steps include:

  • sitting down to pass your urine to avoid splashing urine on a toilet or toilet seat
  • washing your genitals and genital area with soap and water after passing urine to ensure it’s clean of chemotherapy drugs that may have splashed on your skin
  • wash your hands thoroughly after passing urine with soap and water

For 2 days following your treatment, you may be asked to drink 2 to 3 liters (3 1/2 to 5 pints) of fluids a day to help flush the drug out of your bladder.

For many people, intravesical chemotherapy helps to prevent the cancer from growing back in the bladder after the removal of a bladder or kidney tumor. Without it, bladder and kidney cancer is more likely to regrow and progress.

Chemotherapy drugs are potent and carry risk of side effects, some of which may be severe.

Intravesical chemotherapy involves inserting cancer drugs directly into the bladder, instead of into the bloodstream. Because of this, the drugs usually don’t reach and affect other parts of the body. This can help people avoid many side effects linked to other types of chemotherapy treatments.

However, it’s still possible to experience side effects after intravesical chemotherapy treatments. Some common side effects include:

  • discomfort or burning during urination
  • increased need to urinate
  • light red or pink blood in urine
  • small pieces of tissue (bladder lining) in your urine

Serious side effects are possible. Call your doctor right away if you notice:

  • rash on any part of your body
  • feeling feverish or chills
  • your urine is smelly or cloudy
  • genital pain
  • severe abdominal pain

Intravesical chemotherapy is almost always used to treat low-to-medium-risk, nonmuscle invasive bladder cancer, often following TURBT. But in some cases, it’s used to treat more aggressive bladder cancers.

Your doctor will discuss your treatment options with you to develop a plan suited to your needs.

Those experiencing bladder cancer have several treatment options available. Often, however, a medical professional might recommend a variety of treatments in order to best eliminate the cancer.

Systemic immunotherapy, radiation, and systemic chemotherapy are used in cases of more advanced or metastatic bladder cancers.

Bladder cancer surgery

Most cases of bladder cancer require some kind of surgery. Common surgeries used to treat bladder cancer include:

  • transurethral resection of bladder tumor (TURBT) to treat early stage (nonmuscle invasive) bladder cancers
  • cystectomy to treat invasive cases of bladder cancer to remove the entire bladder
  • partial cystectomy to treat cases of bladder cancer where some of the bladder is removed but the rest remains intact
  • radical cystectomy to treat cancer that’s spread across the bladder and nearby lymph nodes


Some bladder cancers are treated with medications that help a person’s immune system recognize and destroy cancer cells. This is called immunotherapy.

Immunotherapy treatments may be administered intravenously, via injection, or directly into the bladder.

Radiation therapy

Radiation therapy involves focusing a beam of radiation on the body externally. It’s often used to treat early stage cases of bladder cancer. It can also be used to treat bladder cancer in people who may not be able to undergo surgery.

Radiation is often used in tandem with chemotherapy.

Systemic chemotherapy

Similarly to intravesical chemotherapy, systemic chemotherapy involves exposure to medications that stop cancer cells from replicating and growing.

Instead of being directly put into the bladder, systemic chemotherapy involves exposing the entire body to the drugs. It can be used to kill cancer cells throughout the body.

Targeted therapy

Targeted therapy involves exposing the body to drugs that have specific effects on bladder cancer cells. For example, targeted therapy can stop growth of bladder cancer cells that resist treatment with chemotherapy.

If your doctor has recently recommended intravesical chemotherapy, you might have questions:

Is intravesical chemotherapy painful?

You may experience some soreness and discomfort during intravesical chemotherapy. You may feel like you have an uncomfortably full bladder during treatment.

Does intravesical chemotherapy cause baldness?

Because intravesical chemotherapy is targeted, it doesn’t typically cause the whole body side effects of other kinds of chemo. For example, most people don’t experience baldness or hair loss as a result of intravesical chemotherapy.

How many rounds of chemo do you need for bladder cancer?

Sometimes, intravesical chemotherapy is used to treat high risk (faster growing) noninvasive bladder cancers. The more aggressive the cancer, the more aggressive the treatment.

A person with a fast-growing cancer may be advised to go through several intravesical chemotherapy treatments for 1 to 3 years, depending on how their bladder cancer responds to treatment.

Should you have sex after having intravesical chemotherapy?

You can have sex after intravesical chemotherapy. However, it’s important to wash yourself and use a condom or other physical barrier to avoid exposing yourself or your partner to chemotherapy medication.

Your doctor or nurse will tell you when it’s safe to stop using barriers during sex.

Intravesical chemotherapy is a useful treatment for some kinds of bladder cancers and less common types of kidney cancer.

Instead of distributing chemotherapy through the body, intravesical chemotherapy targets the bladder. In this type of therapy, chemotherapy drugs are put directly into the bladder using a catheter through the urethra

Often, it’s used after tumor-removal surgery to prevent cancer from regrowing. While the risk of side effects of intravesical chemotherapy tend to be lower than other types of chemotherapies, you still need to take precautions to stay safe and ensure the treatment is effective.