@bajaman , My husband was diagnosed with bladder cancer in 2019 and unfortunately it was quite aggressive. He began with a chemo regimen then went to BCG after an initial partial cystectomy. His cancer returned while on maintenance BCG so he was considered a BCG failure. He is just over a year since a radical cystectomy and neobladder surgery. Part of his maintenance currently and potentially forever is self catheterization 2-3 times daily. Like you, he was very fearful of the discomfort of catheterization, brought on by the repeated cystoscopies. What he found during the scopes and BCG treatments was that different health professionals have different techniques and many have figured out how to eliminate all the pain. The more experienced they were, the better their technique. He learned that waiting a few minutes after the local anesthetic is infused before catheterizing makes a big difference, esp for cystoscopy. If they are in a hurry, ask for those minutes. Lots of lubrication is another factor that helps considerably. Perhaps the biggest thing was to learn to breathe and relax instead of tensing up and holding your breath. That was difficult at first but just comes naturally now. For BCG infusion, you can likely also ask for a smaller catheter size if it is painful. Enlarged prostates in older men make it difficult to pass a catheter and a size smaller may help considerably. He had almost no side effects from BCG, only a slight bit of urgency to urinate the following day. Good luck to you, we hope this treatment is very successful for you. Mayo Scottsdale is a great choice.

Good morning @bajaman. My experience with bladder cancer and BCG treatment might ease your concerns. During transurethral resection of prostate (TURP) tissue, my urologist discovered a small tumor on the surface of the lining of my bladder and removed it. A few weeks later, in examining the bladder and reduced prostate through a resectoscope, the doctor found a dozen more small tumors that were somewhat more advanced, but not growing below the lining into bladder muscle. Walk-in surgery performed another TURP to remove them, and two weeks later I began a weekly BCG treatment of five injections. That was 12 years ago. My bladder has been clear since then, as we have learned with quarterly, then biennial, and now annual inspections with a cystoscope. All of these procedures involved injection of a catheter-like device inserted through the urethra in my penis. This could have caused pain and infection, but it never has, thanks to judicious use of a pain killer and a good antibiotic before a cystoscope is inserted through my urethra. Today, I'm regarded as a survivor of bladder cancer; I don't consider that to be miraculous, but good medical care by a series of three urologists at my HMO clinic a dozen miles away from home. I hope your treatment and recovery is as rewarding as mine has been. Martin