Treatment-Related Cystitis During Intravesical Chemotherapy: Incidence, Risk Factors, And Nursing-Pathway...

Intravesical chemotherapy is routinely used after transurethral resection of bladder tumors for non-muscle-invasive bladder cancer, but treatment-related cystitis (TRC) may disrupt planned care. This retrospective, single-center, observational cohort study quantified TRC incidence, identified associated clinical and procedural factors, and examined the association between a preventive nursing pathway and TRC-related outcomes. We analyzed 120 consecutive patients receiving intravesical chemotherapy and compared patients managed under standard care (n = 60) with those managed under a preventive nursing pathway (n = 60) according to routine clinical pathway assignment. TRC was assessed within 7 days after each documented instillation, and interruption-free completion was evaluated during the documented intravesical treatment course. TRC events were captured from electronic medical records using predefined symptom documentation and follow-up records. Risk factors were evaluated using multivariable regression, and time to event analysis was used to assess treatment interruption attributable to TRC. TRC occurred in 45.8% of patients. A shorter interval from transurethral resection to first instillation (OR = 0.83 per 7-day increase), multiple catheterization attempts (OR = 1.41), and higher baseline symptom burden were associated with increased TRC risk. After adjustment, management under the preventive nursing pathway was associated with lower odds of TRC (aOR = 0.54, 95% CI: 0.29-0.98; P = 0.043). As this study was non-randomized and based on routine care pathway assignment, these findings should be interpreted as adjusted associations rather than evidence of a causal intervention effect. The findings suggest that TRC is a substantial real-world burden during intravesical chemotherapy and that structured nursing documentation, baseline assessment, catheterization quality control, symptom monitoring, and early escalation may support risk-stratified follow-up. As no direct mucosal or biomarker measurements were obtained, urothelial barrier injury is discussed as a plausible mechanism rather than a demonstrated effect.