Management of IC/BPS involves administration of various types of medications to conquer the disease from all fronts. Usually your doctor will provide medications which belong to one of the following categories:
- Analgesics: Pain medications can help to alleviate the feeling of discomfort and urge in the lower abdomen. They must not be taken for a very long durationas they may cause damage to the function of the kidneys
- Neuro-relaxants: Certain medications will be given to relax the nerves which carry signals from the bladder to the brain. These medicines are usually very effective in symptomatic management but can cause a little drowsiness
- Anticholinergics: These medicines relax the bladder muscles and can help in the urgency and frequency symptoms of some patients with IC/BPS. Anticholinergics can cause dry mouth and constipation.
- Muscle Relaxants: In some patients with pelvic floor spams, doctors can prescribe muscle relaxants after thorough examination.
- Pentosan Polysulfate: PPS is useful in recreating and repairing the normal urothelium that has been damanged in IC/BPS but it may take time to show its effect. Patients must take the medicine for the optimal duration before the doctor can judge its response.
- Intravesical agents: These medicines are instilled within the bladder to help heal the urothelium and create a new layer. Once instilled these medicines provide early and adequate relief in symptoms.
- Botulinum toxin: Botulinum toxin can be injected within the bladder to paralyze the pain fibres and bladder musculature that conveys sensation of urge, pain and fullness to the brain. The medication is effective in patients showing poor response to oral medicines but its effect is temporary and may last only for 6 to 9 months.
- Neuromodulation: Neuromodulation is a technique where nerves are stimulated to block pain sensations from bein carried to the brain. This involves stimulation of a nerve in the leg called posterior Tibial nerve. The process is nearly painless and invoves application of low amplitude current.
- Removal of the bladder: In rare and refractory cases there may be a need to remove the bladder and divert the urine. Although this is not successful in relieveing the discomfort in some patients it is one of the last few measures for managment.