What are they?
Sometimes Dr. Kumar will instill medication directly into the bladder for relief of urinary symptoms, via a urethral catheterization (placing small tube into the urethra). This allows medication to work in the bladder without the side effects of oral medication. It is done in the office for patients with painful bladder syndrome (PBS), as well as those who have recurrent urinary tract infections. In women with PBS, the instillation is usually a cocktail of agents designed to calm inflammation in the bladder and rebuild the bladder lining. For recurrent urinary infections, it is usually a solution with an antibiotic.
Why are they necessary?
If you are undergoing workup or have been diagnosed with interstitial cystitis, Dr. Kumar may recommend a bladder instillation to see if this helps your discomfort. If it does, she will have you come in weekly until your symptoms begin to subside and your voiding intervals are longer. If you have recurrent urinary infections despite a good preventative regimen, Dr. Kumar will sometimes recommend bladder instillations with an antibiotic to break the cycle and avoid you having to take oral antibiotics.
Are they painful?
They are not painful. When the small catheter is inserted, you may feel a quick pinching sensation and that is it. The solution is instilled into the bladder and the catheter is removed. Usually you will feel relief of discomfort because of the presence of an anesthetic in the solution.
How long do I need to have them?
The frequency and duration of the instillations will depend largely on your symptoms. If you have been getting these treatments every week for about 4-6 weeks and your symptoms are improved, we may wait longer intervals and eventually stop. Some patients like to do instillations on a regularly scheduled basis, whereas others only need them when they have symptom flares.