Introduction
A number of different medications can be instilled into the bladder to help control the symptoms of a painful bladder. These medications often have properties that reduce inflammation, relive pain and help to replenish the natural protective lining of the bladder.
Indications
Bladder instillations are primarily used to treat painful bladder syndrome.
Preoperative Instructions
A urine test will be performed to ensure the patient does not have an active urinary tract infection, as this will require treatment prior to the procedure. Bladder instillations can be safely performed when the patient is taking medications that increase the risk of bleeding such as warfarin, clopidogrel, apixaban and rivaroxaban. A number of other tests such as an ultrasound scan, urine cytology or cystoscopy may also be performed prior to performing a bladder instillation. There is no requirement to fast prior to a bladder instillation.
Procedure
The patient is typically admitted to the day ward of the hospital. A trained nurse with prepare the bladder instillation before placing a catheter to empty the patient’s bladder. The medication will then be placed into the bladder and the patient is encouraged to try to hold on to the medication for at least 30mins to an hour. After this time, the patient is able to urinate out the medication and they are then discharged home. This is typically repeated as per a particular schedule such as weekly for 4 weeks and then less frequently thereafter. The patient may continue to have a treatment once every month or so if they achieve significant improvement in their symptoms.
Postoperative Instructions
There are no specific post-operative instructions that need to be followed after a bladder instillation. The patient is able to resume all their usual activities. The beneficial effects of a bladder instillation can take a number of weeks to be noticed and patients are advised to persist with the specified duration of the treatment.
Risks
The risks of bladder instillations include:
- Dysuria (burning / stringing whilst urinating).
- Urinary tract infection.
- Aggravating of symptoms.
- Haematuria.
- Trauma from the catheter.
Treatment Alternatives
There are numerous treatment alternatives for painful bladder syndrome. Your surgeon will discuss many of these with you at the time of diagnosis and help to assist you with the treatment option most suitable to your symptoms.