Cystitis
Cystitis is a bladder infection causing inflammation and irritation. The symptoms can include: pain when urinating (dysuria), frequency - a frequent need to urinate, urgency - and urgency to urinate, cloudy urine, blood in the urine (haematuria) and a strong odour.
As an infection is involved, it is absolutely essential to see a doctor who will prescribe an antibiotic and perhaps take a urine sample for analysis. Treatment should not be delayed.
It is important to have good fluid intake, but avoid tea or coffee. Cranberry juice is said to relieve the symptoms.
It is also advisable to shower rather than have a bath.
If bladder infections persist there is a chance of the kidneys becoming infected and specialist treatment may be recommended. See Recalcitrant Bladder Infections for more information.
Interstitial Cystitis
Interstitial Cystitis is a chronically painful bladder. The pain can vary from case to case or from time to time from mild to intense. As the bladder fills, the irritation increases and so sufferers urinate frequently and often the need is urgent.
There is a great variation in symptoms and so many specialists believe that "interstitial cystitis" may be applied to many different diseases that are not fully understood.
A cure for Interstitial Cystitis has not yet been found but there are treatments such as bladder stretching which provide temporary relief of the symptoms.
Painless Bladder Stretching
A bladder distension, stretching the bladder to increase capacity, can provide some relief for interstitial cystitis and is usually the first treatment given.
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.
A general anaesthetic does not relax the bladder muscle so fluid needs to be forced into the bladder. This often causes tearing and bleeding. The result is usually severe discomfort and pain for a time after the procedure before relief is felt.
With EMDA it is possible to anaesthetise the bladder and detrusor muscle so the fluid runs in under gravity and provides a good distension totally painlessly. There is no tearing and bleeding and just minor discomfort sometimes after the procedure.
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 adrenalin.
A small direct current (EMDA or Electromotive Drug Administration) drives the drug solution into the bladder wall. Within a few minutes the bladder is anaesthetised and the bladder muscle relaxes.
With the bladder anaesthetised, painless TURBTs, Biopsies, Cystodistensions etc may be carried out.
For a cystodistension, the bladder muscle relaxes and fluid is fed through the catheter under gravity and the bladder expands until it reaches its normal capacity. All this is painless. After the procedure there may be slight discomfort for 24 - 48 hours.
After a bladder stretch relief from interstitial cystitis symptoms can last up to a year or more.
Genesis Medical supplies the Physioner to produce the electric current and the special catheters.
General Anaesthesia for bladder stretching
A general anaesthetic is used to put the patient to sleep 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 painless and later discomfort is minimal and because the local anaesthetic relaxes the bladder muscle, a greater bladder distension may occur with just 50cm water pressure.
The following web sites provide good information in Interstitial Cystitis and alternative treatment options:
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