Can IC be treated?
Because there is no cure for interstitial cystitis, the goal of treatment is to relieve symptoms. Not everyone with IC responds the same way to the same treatment. What works for one person may not work for another. In addition, IC treatments generally take several weeks to several months to provide relief. When you discuss your treatment options with your doctor, your doctor will help you decide which one might work best for you. Treatment options include:
Bladder distention. Some patients report feeling better after the bladder distention used during diagnosis. Symptoms often worsen within the first two days after distention. But they return to pre-distention levels or improve within two to four weeks. It isn't clear why distention causes symptom relief in some people. It may be that distention increases the capacity of the bladder. Or it may be that it interrupts the pain signals.
Bladder instillation. This is also called a bladder wash or bath. A catheter is used to fill the bladder with a solution of a drug called dimethyl sulfoxide (DMSO). The solution is held in the bladder for an average of 10 to 15 minutes before the bladder is emptied. Treatment is given either every week or every other week for a period of six to eight weeks and then repeated as needed. Improvement is usually seen three to four weeks after the first six- or eight-week cycle.
Pentosan polysulfate sodium is a drug that has been approved by the FDA for treating interstitial cystitis. In some people, the drug can improve symptoms. However, pain relief may not occur for two to four months, and it can take up to six months before there is a decrease in urinary frequency. Doctors urge patients who take the drug to stay with it long enough for the drug to work. The doctor may suggest aspirin and ibuprofen as well as other prescription drugs to help control pain. The doctor may also prescribe a tricyclic antidepressant or an antihistamine. Both have been effective in treating IC.
Electrical nerve stimulation. Sometimes mild electrical pulses are used to stimulate nerves to the bladder. This may increase blood flow to the bladder, strengthen the bladder muscles, and trigger chemicals that block pain. The impulses are sent through the skin using a TENS machine through wires placed on the lower back or just above the pubic area. TENS stands for "transcutaneous electrical nerve stimulation." The electrical impulse can also be delivered using a special device inserted into the vagina for women or into the rectum for men. If nerve stimulation works, there is a device that can be implanted under the skin to deliver regular impulses to the bladder.
Surgery. Surgery is usually reserved for patients with ulcers on the bladder. And it's generally seen as a final option after other treatments have failed to work. But doctors often discourage it because some people will still have symptoms after the surgery. One approach that is used is to remove scarred, ulcerated, and inflamed tissue and then use a piece of the patient's colon to enlarge the bladder.
None of the IC treatments work immediately, and it can take weeks or months before the symptoms improve. And because interstitial cystitis is a chronic condition, most patients need to continue treatment indefinitely to keep the symptoms from returning. It's also important to note that not all patients will become symptom-free. Many still have an issue with frequency or with some level of persistent discomfort.