Open AccessTreatment of interstitial cystitis/painful bladder syndrome as a neuropathic pain condition
Author(s) -
Lakshmi Vas,
Manorama Pattanik,
Vaishali Titarmore
Publication year - 2014
Publication title -
indian journal of urology/indian journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.333
H-Index - 30
eISSN - 1998-3824
pISSN - 0970-1591
DOI - 10.4103/0970-1591.128513
Subject(s) - medicine , interstitial cystitis , pelvic pain , pelvic floor , bladder pain syndrome , neuropathic pain , botulinum toxin , urology , anesthesia , surgery , urinary system
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.