As the duration of intravesical bacillus Calmette-Guérin (BCG) immunotherapy for nonmuscle-invasive bladder cancer (NMIBC) increases, the incidence of bladder cancer recurrence decreases but symptoms of overactive bladder (OAB) requiring medical treatment increases, investigators reported in a poster presentation at the 2021 International Continence Society annual meeting.  

Of 130 patients with mostly high-risk NMIBC, 61 (46.9%) received induction BCG therapy for 6 weeks, 23 (17.7%) received maintenance BCG therapy for 12 months or less, and 46 (35.4%) received maintenance BCG therapy for more than 12 months. Tumor recurrence rates significantly decreased with longer courses of BCG therapy: 59% vs 43.5% vs 6.5%, respectively, Ugur Yucetas, MD, of Health Sciences University, Istanbul Training and Research Hospital in Istanbul, Turkey, and colleagues reported. Similarly, a significantly smaller proportion of patients required cystectomy after more than 12 months of BCG therapy (2.2%), compared with BCG therapy lasting 6 weeks (13.1%) or 12 months or less (21.7%).

Along with these benefits, however, the prevalence of OAB symptoms requiring medical treatment significantly increased from 13.1% to 30.4% and 52.2% of patients with 6 weeks, 12 months or less, and more than 12 months of BCG therapy, respectively, the investigators reported. Patients experienced bothersome urinary urgency and frequency within a mean 8.7 months of BCG initiation.

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“As the duration of intravesical BCG application prolongs … there will be an increase in symptoms of overactive bladder such as urgency and frequency, which will require medical treatment,” Dr Yucetas and colleagues concluded in their study abstract.


Yucetas U, Genc C, Sonmezay E, Kadihasanoglu M, Erkan E, Toktas M. The effect of intravesical BCG treatment on recurrence and bladder overactivity in bladder tumor. Presented at: ICS 2021, October 14-17, 2021. Abstract 380.