Treatment of interstitial cystitis/painful bladder syndrome as a neuropathic pain condition

A lady of 52 years with painful bladder syndrome/interstitial cystitis (PBS/IC) presented with chronic pelvic pain, irritative voiding with sphincter dominance on urodynamics. 3 yrs of oral analgesics, antispasmodics and intravesical therapy was ineffective. We surmised her pain, and irritative void...

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Bibliographic Details
Published in:Indian journal of urology 2014-07, Vol.30 (3), p.350-353
Main Authors: Vas, Lakshmi, Pattanik, Manorama, Titarmore, Vaishali
Format: Article
Language:English
Subjects:
Bladder
Botox injection into pelvic fl oor muscles
Care and treatment
Case Report
Case studies
caudal epidural analgesia
Diagnosis
Interstitial cystitis
Medical treatment
Muscle pain
Nervous system
Pain
painful bladder syndrome
Pathogenesis
Urine
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Summary:A lady of 52 years with painful bladder syndrome/interstitial cystitis (PBS/IC) presented with chronic pelvic pain, irritative voiding with sphincter dominance on urodynamics. 3 yrs of oral analgesics, antispasmodics and intravesical therapy was ineffective. We surmised her pain, and irritative voiding to be secondary to constant straining against a dysfunctional pelvic floor. We treated PBS/IC as a neuropathic phenomenon with a combination of neuromodulator medications and continuous caudal epidural analgesia to reduce the pain induced peripheral and central sensitisation. Botulinum toxin type A injection into pelvic floor muscles appeared to address their dysfuction. Clinical and urodynamics response was encouraging.
ISSN:0970-1591
1998-3824
DOI:10.4103/0970-1591.128513