Diseases & Conditions
treatment exists to eliminate the symptoms of interstitial cystitis, and
no one treatment works for everyone. You may need to try various
treatments or combinations of treatments before you find an approach
that relieves your symptoms.
Your doctor may prescribe an oral medication, pentosan (Elmiron),
the only oral drug approved by the Food and Drug Administration
specifically for interstitial cystitis. How it works is unknown, but
Elmiron may restore the inner surface of the bladder, which protects
the bladder wall from substances in urine that could irritate it. It
may take 3 to 6 months before you begin to feel pain relief and up
to 9 months to experience a decrease in urinary frequency. Side
effects include minor gastrointestinal disturbances and possible
hair loss, which reverses when you stop taking the drug. Not for use
by pregnant women, Elmiron may cause bleeding and loss of pregnancy.
Make sure your doctor knows if you're pregnant.
oral medications that may improve the symptoms of interstitial
cystitis include aspirin and ibuprofen (Advil, Motrin, others) to
relieve mild discomfort. Tricyclic antidepressants, such as
amitriptyline (Elavil) or imipramine (Tofranil), may help relax your
bladder and block pain. Hydroxyzine pamoate (Vistaril) and
hydroxyzine hydrochloride (Atarax) are antihistamines that may
provide symptom relief for some people, especially people who have
allergies, migraines and irritable bowel syndrome in addition to
This therapy uses electrical currents. A method called
transcutaneous electrical nerve stimulation (TENS) can relieve pain
and decrease urinary frequency, particularly in people with Hunner's
ulcers. TENS delivers a relatively painless electric current through
wires placed on your lower back or below your navel. In some cases,
the current is delivered through a special device inserted into the
vagina in women or anus in men. Although no one knows exactly how
TENS works, it may be that the current increases blood flow to the
bladder, that it triggers the release of substances that block pain
or that it strengthens pelvic muscles that help control the bladder.
Researchers are testing sacral nerve stimulators, currently used for
urinary incontinence, for treatment of interstitial cystitis. This
small device, which resembles a pacemaker, is surgically implanted
in your abdomen and acts on nerves to control bladder contractions.
A wire from the device is connected to a sacral nerve — an important
nerve in bladder control that runs from your lower spinal cord to
your bladder. Through the wire, the device emits electrical impulses
that stimulate the nerve.
A small percentage of people notice a temporary improvement in
symptoms after undergoing cystoscopy with bladder distention, the
stretching of the bladder with water or gas. For them, the procedure
may be repeated as a treatment. Symptom relief may last for several
instilled into the bladder.
Another treatment is bladder instillation, in which the prescription
medication dimethyl sulfoxide, or DMSO (Rimso-50), flows into the
bladder through a thin, flexible tube (catheter) or syringe you
insert through the urethra. The solution sometimes is mixed with
other medications, such as local anesthetic.
remaining in the bladder for 15 minutes, the solution is expelled
through urination. Because DMSO is delivered directly to the
bladder, it may effectively reduce inflammation and possibly prevent
muscle contractions that cause frequency, urgency and pain. A
garlic-like taste and odor may last up to 72 hours after treatment,
an annoying but not dangerous side effect. DMSO can affect your
liver, so your doctor will monitor your liver function. Other
instilled medications, such as bacillus Calmette-Guerin, or BCG
(Tice BCG, Pacis, TheraCys), currently used to treat bladder cancer
are being studied in clinical trials for treatment of interstitial
Doctors rarely use surgery to treat interstitial cystitis because
surgery may not relieve symptoms and can lead to other
complications. Only people with severe pain for whom other
treatments have failed are possible candidates for surgery.
surgical option, bladder removal (cystectomy), requires reconstructing
your bladder and rerouting urine. If your doctor recommends surgery,
discuss your options for reconstruction. Two types of surgery that
involve instruments inserted through the urethra remove Hunner's ulcers.
Fulguration involves burning them off with a laser or electricity and
resection involves cutting around them. However, the effectiveness of
these procedures has not been proved.
Interstitial Cystitis (IC)
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