Interstitial cystitis or bladder pain syndrome is not so rare. And all urologists are quire experienced to manage it.
Following is the comprehensive treatment protocol for interstitial cystitis;
1) Medications; Gabapentin, hydroxyzine, montelukast
2) Physical therapy; Pelvic floor physical therapy (PT) may be recommended to decrease tightness in these muscles. PT can decrease bladder or pelvic pain as well as urinary urgency and frequency. The physical therapist works on the patient's body to manually "release" the tightness, tender points, trigger points, and restricted movement of the connective tissues and muscles.
It will help in your leg symptoms also.
3) Exercises; Many patients feel that gentle stretching exercises help relieve symptoms.
4) Electrical stimulation; sacral nerve stimulation.
5) Behavioral therapies; Behavioral therapies for urinary frequency work to slowly increase the time interval between voids, which increases the amount of urine the bladder can comfortably hold; this is called timed voiding.
6) Diet; alcohol, tomatoes, spices, chocolate, caffeinated and citrus beverages, and high-acid foods may contribute to bladder irritation and inflammation. Artificial sweeteners may aggravate the symptoms.
Urinary analgesics and antiseptics such as phenazopyridine hydrochloride, Uromax, and Urised can be helpful for the management of short-term symptom flares.
Several intravesical agents (bladder instillation) are available.
1) Dimethyl sulfoxide (DMSO) is the principle intravesical agent approved.
2) Multidrug cocktails, including DMSO (50 cc), sodium bicarbonate (48 meq), heparin (20,000 units), and triamcinolone acetonide (1 amp) are commonly used.
3) An anesthetic cocktail consisting of bupivacaine (30 cc), heparin (20,000 units), sodium bicarbonate (48 meq), and triamcinolone acetonide (1 amp) can be self-administered on a daily basis.
4) Intravesical oxybutynin (5–10 mg crushed and suspended in 10 cc of water) has also been used to control bladder spasms.
5) Other intravesical agents are; hyaluronidase and bacillus Calmette-Guérin (BCG).
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