Pamm,
Your fathers experience is not what is expected. In the normal course of events, the BCG is retained for 2 hours then voided, or retained as long as possible until voiding occurs prior to 2 hours. I am not always able to retain BCG for 2 hours - I have been told (no authority cited) that one hour is acceptable but not ideal.
It sounds as if his doctor had provided a solution to the problem after the first immediate void (catheter retention) , but the nursing staff either did not receive or did not understand the intended procedure. Talking to the doctor and making notes of the procedure he expects the nursing staff to provide would be helpful. You could then confirm with the nurse, prior to treatment, that the doctor's orders would be followed.
I would consider asking the following questions of the doctor. .When MY care is not going as I expected, I like to define expectations in advance. Some doctors have not appreciated my questions and attitude.
- Is there a physical cause for the short retention ?
- How long must BCG be held in the bladder to be effective ?
- At how short a hold time is the treatment considered ineffective ?
- If a catheter is used to force retention, will a nurse be immediately available in case of extreme discomfort or urgent need to urinate ?
- When using a catheter to extend hold time, will the goal be to hold BCG for 2 hours ?
One clinical trial noted that 10% of patients quickly void BCG.
www.endo.com/File%20Library/Clinical%20Trials/Clinical%20Trial%20Results/EN3329-A9301-A9302-abstracted-synopsis-external-posting.pdf
Clinical Trial Results Summary Study EN3329-A9301/A9302
"Nine patients (10%) received seven or eight doses; in all cases, the patients had been unable to retain one or more of the scheduled doses for more than a few minutes, so extra doses were administered."
Thanks for being there for your dad.
Best
Jack