Work

Alopecia following single-dose postoperative intravesical gemcitabine in nonmuscle-invasive bladder cancer: A multi-institutional case series

Year: 2026

Type: article

Abstract: INTRODUCTION: Single-dose intravesical gemcitabine therapy (IVGT) is a standard of care option following transurethral resection (TURBT) for low- to intermediate-risk nonmuscle invasive bladder cancer (NMIBC). The side-effect profile of IVGT has primarily focused on well-established urinary symptoms. Herein we present several cases of treatment-related alopecia following a single postoperative dose of IVGT for NMIBC. METHODS: Urologic oncologists from 7 high-volume bladder cancer referral centers in the United States were surveyed about incidents of alopecia, as well as the severity of hair loss, following a single postoperative dose of IVGT after TURBT- either for primary or for known NMIBC. Patients were identified either through self-reported concerns or by physician-observed alopecia during follow-up visits. RESULTS: Between January 2020 and December 2024, a total of 20 patients (6 male, 14 female) experienced hair loss, with the majority (N = 12, 60%) occurring within the first month post-TURBT. Thirteen of the 20 patients (65%) experienced severe alopecia. None of the patients were on medications known to cause hair loss or receiving other chemotherapy. Five patients had large resections (>5 cm), ten had medium (2-5 cm), and 5 had small (<2 cm) resections. Two patients had previously received IVGT without hair loss. Additionally, 4 patients had previously received intravesical Bacillus Calmette-Guérin (BCG), and 1 had received intravesical mitomycin C. No cases of bladder perforation were reported. CONCLUSION: Hair loss appears to be an underreported side effect of IVGT post-TURBT. Patients should be counseled about this potential adverse event prior to treatment, and routine inquiry regarding alopecia should be considered in those undergoing IVGT post-TURBT. Prospective multicenter studies are encouraged to better evaluate the incidence and risk factors associated with this adverse event.

Source: Urologic Oncology Seminars and Original Investigations

DOI: 10.1016/j.urolonc.2025.12.020