 |
Bladder Stretching or Cystodistension
A bladder distension, stretching the bladder to increase capacity, can provide relief and may be the first treatment given for interstitial cystitis. For most people there is relief which lasts for periods of time varying from weeks to months and for some even to several years.
Anaesthesia is essential for a bladder distension operation. This may be under a general anaesthetic or with a local anaesthetic delivered by Electromotive Administration (EMDA) and the procedures are very different.
Local Anaesthesia by EMDA
A special catheter incorporating an electrode is used to fill the bladder with a solution of lignocaine (an anaesthetic), dexamethasone ( a steroid) and 1/100,000 adrenaline.
A small direct current the drives the drug solution into the bladder wall. Within a few minutes the bladder is anaesthetised and the bladder muscle relaxes. Fluid is then fed through the catheter and the bladder continues expanding until it reaches its normal capacity. All this is painless. After the procedure there may be just slight discomfort for 24 - 48 hours.
Relief from symptoms can last up to a year or more. If the symptoms return, another procedure can be carried out and relief is often extended for longer periods with successive treatments.
Treatments are easily carried out in the hospital outpatients department by a nurse. Immediately after the bladder stretch the patient can return home or to work.
On the UK IC bulletin board an IC sufferer describes her experience of bladder stretching with EMDA and after her follow up treatment she sent Genesis Medical an email
Genesis Medical supplies the Physioniser to produce the electric current and the special catheters.
General Anaesthesia
A general anaesthetic is used to put the patient to sleep. A catheter is inserted into the bladder and fluid is allowed to flow into it. The general anaesthetic does not relax the bladder muscle and so this resists the bladder expanding. If fluid is forced under pressure the bladder wall will usually tear and bleed. After waking from the general anaesthetic severe pain and discomfort is frequently felt for as long as several days.
Once the pain subsides, relief from symptoms can last for months or up to one year, sometimes longer.
A bladder distension under local anaesthetic, EMDA, is very much better tolerated than the procedure under a general anaesthetic. Because the local anaesthetic relaxes the bladder muscle, a greater bladder distension occurs with less pressure (50cm water pressure is sufficient).