Treatments

At this time there is no cure for IC. There are, however, many available treatment options to help relieve symptoms.

• Oral medicines: Oral medicines, including both pain and non-pain medicines, are used to treat IC symptoms. These include:
  
  • Pain medicines
  • Elmiron
  • Other oral medicines
• Topical medicines: Medicines, applied topically as gels, creams, suppositories and patches, may cause less systemic side effects.
• Bladder retraining: People who have found adequate relief from pain may be able to reduce frequency by using bladder training techniques. Recording voiding times in a diary may help track progress.
• Hydrodistention: Bladder distention, also known as hydrodistention, can help improve symptoms in some patients.  In many cases, this procedure is used as both diagnostic test and initial therapy.
• Physical therapy: Targeted physical therapy for treating underlying pelvic floor dysfunction (PFD) can yield positive results and provide significant pain relief.  Working with a physical therapist who understands IC is the key, because Kegel exercises, often recommended to strengthen pelvic muscles, can worsen IC pain.
• Bladder instillations: Some people with IC benefit from bladder instillations, meaning that a medicine is slowly infused into the bladder through the urethra via a catheter.  Bladder instillations can be used alone or in combination as bladder cocktails. Examples include:
  • DMSO
  • Sodium hyaluronate
  • Heparin
  • Bladder cocktails
• Electrical nerve stimulation: Neuromodulators are small, surgically implanted devices that send mild electrical pulses to nerves in the lower back and help manage urinary function and relieve IC symptoms.  Nonsurgical external devices are also available, including TENS units.
• Surgery: Hunner's ulcers (or patches), present in 5 to 10 percent of IC patients, are treated with laser surgery.  Otherwise, bladder surgery is considered only as a last resort.  Several types of surgeries have been used to treat IC that is unresponsive to all other therapies, including bladder augmentation, urinary diversion, and construction of an internal pouch.

While not FDA-approved for the treatment of IC, Botulinum toxin type A (BTX-A or Botox) is used to treat many conditions of the bladder, including IC.  Botox is thought to work by blocking the sensory nerves in the bladder that transmit pain, spasticity, and inflammation.  It requires direct needle injections into the bladder.

Non-invasive self-help measures, from gentle exercises to pain-relieving techniques, may be used in combination with other, more traditional medical therapies, and are considered a first step in relieving IC symptoms:

• Self-Help: There are things you can do to help relieve.
• Diet modification: Certain foods and drinks may contribute to bladder irritation and inflammation.
• OTC products: While some vitamins and supplements may cause IC flares, many over-the-counter products may be helpful to people with IC.

Revised July 13, 2009