Intravesical therapy

When patients have significant pain arising from the bladder, medicine can be directly placed into the bladder using a very small catheter (I use a 7 French feeding tube-smaller than a small spaghetti noodle).  There are many different medications that can be used based upon your particular problem.  The most common involves instillation of a local anesthetic, heparin and bicarb.  We would expect a patient to have marked improvement in pain symptoms with this instillation for at least 2-4 days if the patient is experiencing significant pain from their bladder.  This becomes a diagnostic tool to determine if your pain is bladder centric or not.  The bladder treatments provide temporary benefit but are typically given in a series so that over time they attempt to heal the hypersensitive nerves and the lining of the bladder-called the urothelium.  After 4-6 treatments most patients can taper their treatment sessions as the other therapies provided for your bladder pain syndrome have started to work.