Medical intervention
Medication
Symptoms can be controlled by oral medications including painkillers, anti-inflammatories and anti-histamines, as well as medications that help relax the bladder muscles or help repair the bladder lining.
If you have more severe symptoms anti-depressants and anti-epileptic drugs can be used to dampen nerve responses. These drugs are often used in combination and can be very effective treatments, but should only be used under the guidance of a specialist.
Bladder distension
The bladder is stretched with fluid, which can aid diagnosis and may temporarily relieve symptoms.
Bladder instillations
The bladder is filled with a liquid solution that contains a mixture of GAG-like compounds such as hyaluronic acid. For the best results, it should be retained in the bladder for at least 30 minutes before being drained through a catheter. Instillations are usually repeated on a weekly cycle for six weeks and then once a month until your symptoms resolve. It’s important to make sure you aren’t discouraged if the treatment doesn’t work immediately, as you might need five or six treatments before symptoms improve.
Botulinum toxin injections
A substance called botulinum toxin is injected directly into the bladder to temporarily relieve symptoms.
Electrical nerve stimulation
Mild electrical pulses are used to stimulate the nerves to the bladder through the skin or with an implanted device in weekly sessions to relieve pain.
With Transcutaneous Electrical Nerve Stimulation (TENS) impulses are delivered through the skin on trigger points such as the lower back, perineum, pubic area or by placing special devices into the vagina (in women) or rectum (in men).
Percutaneous Tibial Electrical Nerve Stimulation (pTENS) is when electrical stimulus is applied through acupuncture needles placed in the ankle to stimulate the tibial nerve, which also supplies the bladder.
However, the implantation of a Sacral Nerve Stimulator (SNS) is the most recent development. When the nerves to the bladder are stimulated directly through the sacrum in the lower back.
Surgery
Surgery will only be considered if other treatments don't work and the pain is disabling.