Interstitial Cystitis Treatment

Interstitial Cystitis is the medical term to describe the chronic inflammation of the bladder wall which gives rise to the following symptoms:

1. The need to urinate frequently and urgently.
2. Experiencing a painful, burning sensation while urinating.
3. Decreased bladder control abilities.
4. Pain in the pelvic area
5. Intense Pain during intercourse.
Interstitial Cystitis is not a life-threatening condition but it severely impacts the patient’s ability to lead a normal life.

The reason for the development of Interstitial Cystitis is still unknown as a result of which the mode of Interstitial Cystitis Treatment is one of trial and error primarily aimed at controlling the symptoms in a patient.

The major methodologies of Interstitial Cystitis Treatment are given below:

1. Oral Medication: The heparinoid (heparin-like) drug, PentosanPolysulfate Sodium otherwise known as Elmiron is the most common oral medication which is used in Interstitial Cystitis Treatment. Pain alleviation medication or some anti-seizure drugs are also used to manage the pain experienced by patients in this condition.
Anti-Allergic drugs (antihistamines) may also be prescribed to control allergic symptoms that could be aggravating a patient’s condition.

2. Bladder Distension: This procedure is a temporary one which provides relief in terms of reducing the urination frequency and alleviation of pain to patients for periods ranging from three weeks to six months.
Bladder Distension is performed under general anaesthesia and basically involves stretching the bladder capacity.

3. Bladder Instillation: This procedure is more commonly known as a “Bladder Bath”. Under this, the bladder is filled with a solution known as Dimethyl Sulfoxide (DMSO) that is held in the bladder for durations ranging from 5 seconds to 15 minutes before being drained out through a catheter.
It is believed that as the medicated solution directly touches the bladder walls, it reaches the tissues more effectively to stem the inflammation and prevent the pain causing muscle spasms which also lead to the frequency and urgency in urination.

4. Surgery: Surgery is considered as an option in Interstitial Cystitis Treatment where the presence of Huner’s Ulcers is found on the bladder walls. There are two main types of surgery :

(i) Fulguration - This involves the burning of the ulcers with a laser.
(ii) Resection - This involves cutting around and removing the ulcers.

5. Bladder Augmentation: This is another surgical procedure where the damaged portions of the bladder are removed and a portion of the patient’s large intestine is re-shaped and attached to the remaining healthier portion of the bladder.

6. Transcutaneous Electrical Nerve Stimulation (TENS): Mild electrical pulses are made to enter the body for two or more times in a day. It is believed that the electrical pulses increase the blood flow to the bladder, strengthen the pelvic muscles that control the bladder and trigger the release of hormones that block pain. TENS is popularly used in Interstitial Cystitis Treatment morefor pain management.

7. Cystectomy:In extremely cases of Interstitial Cystitis, a Cystectomy may have to be carried out to remove the bladder completely with the diversion or re-routing of urine flow.

Having looked at the medical treatment of Interstitial Cystitis, it is imperative to mention here that for most patients, this condition involves some basic medication and more of lifestyle discipline and control in terms of:

(i) Diet Management by avoiding those foods which aggravate the symptoms in the patient. This again is variable as a set of food items which trigger off the symptoms in one person may not do so in another.
(ii) Avoiding smoking, alcohol and recreational drugs.
(iii) Exercise or Yoga to control and strengthen the bladder muscles and manage pain.
(iv) Bladder Training through counselling by using relaxation methods to control the frequency of urination.
The most interesting characteristic of Interstitial Cystitis is that the symptoms are not consistent in their intensity in many cases they even disappear completely without any form of Interstitial Cystitis Treatment.

Interstitial Cystitis

Interstitial Cystitis is more commonly known as the “Painful Bladder Syndrome (PBS)”. It is a physically debilitating condition but fortunately, it is not a life threatening one. This is found to occur more frequently in women between the ages of 30 and 40 than in men. The exact cause of Interstitial Cystitis is still unknown and many theories that have been propounded as to its exact causes are still under aggressive research. Some of these are:

(i) The presence of some unknown substance in the urine of the patients that damages and prevents the regeneration of the epithelial cells which line the walls of the bladder.

(ii) The presence of Huner’s Ulcers (patches of broken skin) on the bladder walls in a large of number of patients with this condition.

(iii) The hyper-activation of sensory nerves in the bladder wall which give rise to this condition.

(iv) The presence of some unidentified micro-organism in the bladder which may be causing damage to the bladder walls.

What actually occurs in “Painful Bladder Syndrome” is that ulcers or scars develop on the walls of the bladder which leads to the scarring and stiffness of the bladder and thereby hampering its normal function in the ejection of urine out of the body. Interstitial Cystitis is typically indicated by the following symptoms:

1. An excessive and frequent need to urinate.

2. The experiencing of a burning sensation during the act of urination.

3. A decrease in the ability to control the bladder.

4. Pain in the pelvic area

5. The experiencing of a burning sensation during intercourse

6. For men, the experiencing of pain in the penis and its immediate surroundings.

The diagnosis of Interstitial Cystitis is made after eliminating all other serious conditions that afflict the urinary tract. Some of the tests which a patient needs to undergo for the diagnosis of the “Painful Bladder Syndrome” are:

1. Bladder Biopsy

2. Cystoscopy (telescopic examination of the bladder)

3. Urinalysis

4. Urine culture

5. Urodynamics (shows how much urine must be in the bladder before you feel the need to urinate)