There are many conditions that can affect the bladder, often resulting in symptoms such as pain or incontinence. Those who suffer from chronic bladder problems might benefit from bladder instillations, also known as bladder cocktails. By getting the medication directly to the affected area, patients may feel relief that can last with repeated treatments.
Your physician will decide which medication or which combination of medicines will work best for your situation. These medicines are made into a solution that is placed directly into the bladder through the insertion of a catheter. This solution is held within the bladder for a certain amount of time before either being drained via a catheter or through regular urination. The medication can provide relief from pain or may even provide direct placement of chemotherapy medications in those with cancers of the urinary tract. Bladder instillations may also be used to expand the capacity of the bladder by stretching out the bladder walls to allow for the holding or more urine.
Who is a Candidate?
As a second course of treatment, instillations may be tried after other remedies and lifestyle changes have not provided significant results. Many different health problems can be alleviated through the use of bladder instillations.
Interstitial cystitis, often referred to as painful bladder syndrome, can result in discomfort and pain that ranges from mild discomfort to severe pain in the bladder and the pelvic region. Patients may have an urgent need to urinate or may urinate more frequently. Dimethyl sulfoxide has been shown to be effective in treating painful bladder symptoms. Dimethyl sulfoxide can be used in a solution by itself or in combination with other medications such as lidocaine and heparin.
Bladder cancer may be treated with medications that can come in direct contact with the cancer cells. Valrubicin or topical chemotherapy medications are some of the medicines that might be used in an instillation that is directly placed into the bladder. While the current instillations are made into a solution that must be held for some time before being expelled, newer advances may include the use of a special gel as a carrier that can hold the medication in place for a longer period of time.
Incontinence, including incontinence that occurs due to idiopathic detrusor overactivity, may also be alleviated through the use of bladder instillations. Dimethyl sulfoxide has been shown to provide some relief. Studies that combine this medication with botulinum type A toxin have also proven to be effective.
What to Expect
Before the procedure, you may be asked to urinate to empty the bladder, or it will be drained through the use of a catheter. The physician may use an anesthetic gel to numb the urethra before inserting the catheter. Once the solution is instilled into the bladder, the physician will provide instructions on how long to hold in the fluid before urinating. Following the procedure, there may be an increase in pain or pressure, but this should subside within a few days.