Third-Line Treatments for Interstitial Cystitis
If second-line treatments don’t work, your doctor will likely turn to the third-line treatments. They require cytoscopy, a special scope used to look at the bladder, often in an operating room under anesthesia.
If you haven’t been seen by a urologist, a doctor who specializes in treating bladder problems, your doctor may refer you to one now.
Bladder stretching. Slowly stretching the bladder wall with fluid may help relieve symptoms. If it’s helpful, the effect usually lasts less than 6 months. Repeat treatment may help.
Steroids. If you have ulcers called Hunner’s lesions on your bladder, a doctor may remove them, burn them, or inject them with steroids.
Dimethyl sulfoxide (DMSO). For people who haven’t found relief through other drugs, this drug is placed in the bladder with a catheter. It’s believed to work by fighting inflammation and blocking pain. Doctors don’t often recommend it because it may temporarily worsen symptoms and takes multiple doctor visits.
Fourth-Line Treatments for Interstitial Cystitis
If lifestyle changes, medications, and the procedures mentioned above aren’t enough, and your symptoms badly affect your quality of life, an urologist may try the fourth line of treatments:
Neurostimulation. The doctor implants a device that delivers small electrical shocks to your nerves to change how they work.
OnabotulinumtoxinA (Botox) injections. This temporarily paralyzes the bladder muscle to help relieve some of the pain.
Final Steps in Interstitial Cystitis Treatment
When all else fails, here’s what you could try:
Cyclosporine. This drug suppresses your immune system.
Surgery. In very rare cases when nothing else works, this may be an option. This is a complex operation that diverts your urine away from your bladder.
Even if IC treatments don’t work for you, pain management using painkillers, acupuncture, or other methods can keep symptoms at bay.