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Treatment - pain control


Pain control is usually necessary in the IC/PBS treatment plan. The pain of IC/PBS has been rated equivalent to cancer pain and may lead to central sensitization if untreated.

  • Medication. The use of a variety of traditional pain medications, including opiates and synthetic opioids like tramadol, is often necessary to treat the varying degrees of pain. Even children with IC/PBS should be appropriately addressed regarding pelvic pain, and receive necessary treatment to manage it.
  • Neuromodulation. Neuromodulation can be successful in treating IC/PBS symptoms, including pain. Electronic pain-killing options include TENS. PTNS stimulators have also been used, with varying degrees of success. Percutaneous sacral nerve root stimulation (PNS) was able to produce statistically significant improvements in several parameters, including pain.
  • Acupuncture. A 2002 review study reported that acupuncture alleviates pain associated with IC/PBS as part of multimodal treatment. While a 1987 study showed that 11 of 14 (78%) patients had a >50% reduction in pain, another study (published in 1993) found no beneficial effect. A 2008 review found that although there are hardly any controlled studies on alternative medicine and IC/PBS, "rather good results have been obtained" when acupuncture is combined with other treatments.
  • Biofeedback. Biofeedback, a relaxation technique aimed at helping people control functions of the autonomous nervous system, has shown some benefit in controlling pain associated with IC/PBS as part of a multimodal approach that may also include medication or hydrodistention of the bladder.

Other articles from the section: Interstitial cystitis

Treatment - surgery

  Surgical interventions are rarely used for IC/PBS. Surgical intervention is very unpredicatable for IC/PBS, and is considered a treatment of last resort when all other treatment modalities have failed and pain is severe. Some patients who opt for surgical intervention continue to experience pain after surgery. Surgical interventions for IC/PBS include transurethral fulguration and resection of ulcers, using electricity/laser; bladder denervation, where some of the nerves to the bladder are cut (Modified Ingelman-Sundberg Procedure); bladder augmentation; bladder removal ...

Section: Interstitial cystitis

Treatment - medication (bladder instillations)

  DMSO, a wood pulp extract, is the only approved bladder instillation for IC/PBS yet it is much less frequently used in urology clinics. Research studies presented at recent conferences of the American Urological Association by C. Subah Packer have demonstrated that the FDA approved dosage of a 50% solution of DMSO had the potential of creating irreversible muscle contraction. However, a lesser solution of 25% was found to be reversible. Long term use is questionable, at best, particularly given the fact that the method of action of DMSO ...

Section: Interstitial cystitis

Treatment - medication (Amitriptyline)

  Amitriptyline can reduce symptoms in patients with IC/PBS. Patient overall satisfaction with the therapeutic result of amitriptyline was excellent or good in 46%.    

Section: Interstitial cystitis

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