Bladder Instillation as a Treatment for Interstitial Cystitis
During a bladder instillation, also called a bladder wash or bath, the bladder is filled with a solution that is held for varying periods of time, averaging 10 to 15 minutes, before being emptied.
The only drug approved by the FDA for bladder instillation is dimethyl sulfoxide (DMSO, RIMSO-50). DMSO treatment involves guiding a narrow tube called a catheter up the urethra into the bladder. A measured amount of DMSO is passed through the catheter into the bladder, where it is retained for about 15 minutes before being expelled.
Treatments are given every week or two for six to eight weeks and then repeated as needed. Most people who respond to DMSO notice improvement three or four weeks after the first six- to eight-week cycle of treatments. Highly motivated patients who are willing to catheterize themselves may, after consultation with their doctor, be able to have DMSO treatments at home. Self-administration is often less expensive and more convenient than going to the doctor's office.
Doctors think DMSO works in several ways. Because it passes into the bladder wall, it may reach tissue more effectively to reduce inflammation and block pain. It may also prevent muscle
contractions that cause pain, frequency, and urgency.
A bothersome, but relatively insignificant, side effect of this form of treatment for
interstitial cystitis is a
garlic-like taste and odor on the breath and skin that may last up to 72 hours after treatment. Long-term treatment has caused
cataracts in animal studies, but this side effect has not appeared in humans. Blood tests, including a complete blood count and kidney and liver function tests, should be done about every six months.
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