Treatment of bladder cancer with Bacille Calmette-Guerin (BCG) involves instillation of viable organisms within the urinary bladder. These organisms are infectious and so the urine needs to be handled as infectious waste.
All equipment used during the instillation of the BCG should be cleaned with all precautions and all waste disposed of as biohazardous.
The solution with BCG is kept in the bladder for as long as possible, up to 2 hours.
Period of infectivity after instillation: 6 hours after first passage of urine (8 hours will be used in the implementation to include the period of fluid retention)
All urine passed during the period of infectivity should be treated with an equal volume of fresh household bleach for 15 minutes prior to being flushed.
Additional safeguards:
(1) The person should pass urine while seated to avoid urine splashing out of the toilet.
(2) Underwear should be changed and washed, preferably in hot water and bleach.
(3) The patient should increase fluid intake for several hours after treatment (unless contraindicated). This helps to flush the bladder.
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