An Introduction to Interstitial Cystitis-the Treatment

Like all chronic illnesses, there is no cure for Interstitial Cystitis (IC), although timely treatment can help reduce the impact of common symptoms such as bladder pain and urinary urgency, and a remission in most cases. However, patients may need to try multiple treatments, and even multiple combinations of treatments in order to determine the most effective route.

1- Lifestyle Changes:

• Work with a physical therapist on exercises for pelvic pain caused by muscle abnormalities and tenderness in the pelvic floor. However, common pelvic floor exercises for urgency control, like Kegels, may worsen symptoms and are hence, not recommended.
• Remove possible bladder-irritants such as caffeine, citrus products, vitamin C-containing foods, and carbonated beverages from your diet to help reduce IC-caused discomfort.
• Train your bladder to hold urine by timing your bathroom trips starting from half-hour intervals and gradually extending them with time. Try slow breathing and distracting yourself if waiting becomes difficult.
• Simple stretching exercises may help with symptom relief.
• Avoid anything that puts pressure on your belly, including belts and tight clothing.

2- Medication:

• Pentosan polysulfate sodium, a specialised IC medication, protects the bladder from possible irritants in the urine by restoring its inner wall; with notable pain relief and reduced urinary frequency in 4 and 6 months, respectively.
• Antihistamines (allergy medications) also help reduce frequent urination and urgency.
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDS) such as ibuprofen and tricyclic antidepressants like amitriptyline may help with pain relief and bladder relaxation, respectively.
• Cyclosporine may be prescribed as a last resort if all other treatments are unsuccessful, due to its numerous side-effects and its ability to reduce the immune system’s function.
• Dimethyl sulfoxide may also be directly administered via a catheter into the bladder (Bladder Instillation), and expelled out alongside urine after staying in the bladder for 15 minutes. Treatments are weekly for 6-8 weeks, followed by maintenance treatments for nearly a year.

Note: Certain antidepressants and painkillers may worsen symptoms.

3- Nerve Stimulation:

• Transcutaneous Electrical Nerve Stimulation (TENS) works by sending mild electrical pulses to the bladder, for varying lengths depending upon the patient’s requirements, via electric wires placed above the pubic area or on the lower back in order to help relieve pelvic pain and reduce urinary frequency.
• Sacral Nerve Stimulation works to reduce urinary urgency and frequency by sending electrical impulses via a thin wire placed near the sacral nerves-which link the spinal cord to the bladder nerves. While initially temporary, the wire may be permanently surgically implanted based on the treatment

4- Surgery:

• Fulguration involves burning off any ulcers causing IC symptoms on the bladder using special instruments inserted via the urethra (the hole for urine excretion).
• Resection works by cutting off IC symptom-causing ulcers in the bladder using special instruments inserted through the urethra.
• Bladder Augmentation involves increasing the bladder’s urine-holding capacity by attaching a patch from the large intestine to the bladder. However, it does not reduce pain, and a catheter may be required multiple times a day for bladder emptying. The bladder may also be removed entirely in some cases.

Note: Due to numerous other complications, surgery is usually reserved for severe cases, or for those with minimal bladder volume, provided that all other treatments are ineffective.

Since IC can recur despite a complete remission, never discontinue your medications, and try to avoid IC triggering, foods, activities, and stress. If you observe a recurrence of symptoms, contact your doctor. You can also book an appointment with a Urologist in Islamabad, Multan and Lahore through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your bladder troubles.