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Instilled Medications

© Lisa Griggs

Bladder instillation refers to the process of filling the bladder with medication (or some other type of therapeutic solution). I have gathered some information on some of the instilled medications that are currently used to treat Interstitial Cystitis.

DMSO (dimethyl sulfoxide) was used for many years as an industrial solvent. It was eventually discovered to have anti-inflammatory properties, and was soon being used for medicinal purposes. In 1978, the Food and Drug Administration approved its use in treating Interstitial Cystitis. It has quickly become one of the most common therapies for IC. The DMSO used today is a sterile, purified, liquid version of the industrial solvent. It is also known by its brand name, RIMSO-50.

DMSO is thought to work by coating the bladder, possibly replacing the thin or damaged lining. This action protects the sensitive muscle tissue from irritants such as urine and bacteria. DMSO has been shown to be effective in approximately 50% of IC cases. Some patients require several treatments before they notice any improvement, while others feel immediate relief. DMSO is usually administered every 2-4 weeks for several months, or more often if needed. The medication is instilled in the bladder via catheter, held for 10-20 minutes, and then released. This process can be uncomfortable. Frequent catheterization can cause irritation, but this can be controlled through the use of anesthetics, or by using a pediatric catheter. The medication itself may be irritating to some patients. The physician can instill a numbing medication into the bladder before the actual treatment, decreasing or eliminating the pain for some patients.

In most cases, the side effects of DMSO are minimal. An odor to the body and breath, and a garlic-like taste in the mouth are the most common. This may continue for 24 hours after treatment. For more information:

http://dmso.org

Heparin is another anti-inflammatory drug that can provide relief by coating the bladder. Heparin seems to be similar to DMSO in its ability to alleviate the pain associated with IC. Sometimes DMSO and Heparin are used together.

Heparin has been given by injection, but instillation is the preferred method. It is held in the bladder for 20-30 minutes before being released. Side effects are minimal, generally related to the use of the catheter. Some patients receiving Heparin injections have developed osteoporosis, possibly caused by extended use of the drug.

Cystistat's main ingredient is hyaluronic acid, which occurs naturally in humans. It is thought to protect the bladder from irritants. Cystistat has not yet been approved by the FDA, but it is available on a limited basis to doctors in Canada and the US.