Abstract：
BACKGROUND: Intravesical instillations of mitomycin C, epirubicin and BCG are considered as the standard treatment for most patients diagnosed with non-muscle invasive bladder cancer. These guidelines aim to optimize the adjuvant intravesical treatment in order to increase the efficacy and lower the morbidity associated with its administration.
METHODS: We conducted a daily practice survey, an online search of available national regulation recommendations and of published guidelines. A bibliography search in French and English using Medline® and Embase® with the keywords \"BCG\"; \"mitomycin C\"; \"epirubicin\"; \"bladder\"; \"complication\"; \"toxicity\"; \"adverse reaction\"; \"prevention\" and \"treatment\" was performed November 2021.
RESULTS: Patient information should be given by the attending physician before the first intravesical instillation. A medical exam to look for specific contraindications is also mandatory to select adequate candidates. Intravesical instillations should be delivered in health-care centers where urologic endoscopic procedures are routinely performed. Attending urologist or specialized nurse should check for negative pretreatment urine test. Intravesical instillation can only be delivered after bladder catheter has been inserted in the bladder without any injury of the lower urinary tract. The pharmaceutical agent should be kept in the bladder for two hours. Finally, voiding within the 6hours following intravesical instillations should be done in the sitting position and the patient should drink at least 2 liters of water per day for 2 days.
CONCLUSIONS: The delivery of intravesical instillations of mitomycin C, epirubicin and BCG should follow a standardized procedure for better efficacy and lower morbidity.
METHODS: We conducted a daily practice survey, an online search of available national regulation recommendations and of published guidelines. A bibliography search in French and English using Medline® and Embase® with the keywords \"BCG\"; \"mitomycin C\"; \"epirubicin\"; \"bladder\"; \"complication\"; \"toxicity\"; \"adverse reaction\"; \"prevention\" and \"treatment\" was performed November 2021.
RESULTS: Patient information should be given by the attending physician before the first intravesical instillation. A medical exam to look for specific contraindications is also mandatory to select adequate candidates. Intravesical instillations should be delivered in health-care centers where urologic endoscopic procedures are routinely performed. Attending urologist or specialized nurse should check for negative pretreatment urine test. Intravesical instillation can only be delivered after bladder catheter has been inserted in the bladder without any injury of the lower urinary tract. The pharmaceutical agent should be kept in the bladder for two hours. Finally, voiding within the 6hours following intravesical instillations should be done in the sitting position and the patient should drink at least 2 liters of water per day for 2 days.
CONCLUSIONS: The delivery of intravesical instillations of mitomycin C, epirubicin and BCG should follow a standardized procedure for better efficacy and lower morbidity.
摘要：
背景：膀胱内滴注丝裂霉素C，表柔比星和卡介苗被认为是大多数诊断为非肌层浸润性膀胱癌患者的标准治疗方法。这些指南旨在优化辅助膀胱内治疗，以提高疗效并降低与其给药相关的发病率。
方法：我们进行了日常实践调查，在线搜索可用的国家法规建议和已发布的指南。使用Medline®和Embase®进行法语和英语的参考书目搜索，关键字为“BCG”；“丝裂霉素C”；“表柔比星”；“膀胱”；“并发症”；“毒性”；“不良反应”；“预防”和“治疗”于2021年11月进行。
结果：患者信息应由主治医师在首次膀胱内滴注前提供。体检以寻找特定的禁忌症也是强制性的，以选择足够的候选人。膀胱内滴注应在常规进行泌尿外科内镜手术的医疗保健中心进行。就诊的泌尿科医生或专业护士应检查尿前试验阴性。膀胱内滴注只能在膀胱导管插入膀胱后进行，而不会对下尿路造成任何伤害。药剂应在膀胱中保存两小时。最后,膀胱内滴注后6小时内的排尿应以坐姿进行，患者应每天至少喝2升水，持续2天。
结论：丝裂霉素C的膀胱内滴注，表柔比星和卡介苗应遵循标准化程序，以获得更好的疗效和更低的发病率。
方法：我们进行了日常实践调查，在线搜索可用的国家法规建议和已发布的指南。使用Medline®和Embase®进行法语和英语的参考书目搜索，关键字为“BCG”；“丝裂霉素C”；“表柔比星”；“膀胱”；“并发症”；“毒性”；“不良反应”；“预防”和“治疗”于2021年11月进行。
结果：患者信息应由主治医师在首次膀胱内滴注前提供。体检以寻找特定的禁忌症也是强制性的，以选择足够的候选人。膀胱内滴注应在常规进行泌尿外科内镜手术的医疗保健中心进行。就诊的泌尿科医生或专业护士应检查尿前试验阴性。膀胱内滴注只能在膀胱导管插入膀胱后进行，而不会对下尿路造成任何伤害。药剂应在膀胱中保存两小时。最后,膀胱内滴注后6小时内的排尿应以坐姿进行，患者应每天至少喝2升水，持续2天。
结论：丝裂霉素C的膀胱内滴注，表柔比星和卡介苗应遵循标准化程序，以获得更好的疗效和更低的发病率。
