From the Research
Sterile cystitis, also known as interstitial cystitis, is a chronic condition that requires a multimodal treatment approach, including oral medications, intravesical instillations, and behavioral interventions, as recommended by the most recent study 1. The diagnosis of sterile cystitis is based on symptoms such as bladder pain, urinary frequency, urgency, and nocturia, without detectable bacterial infection in urine cultures.
Treatment Options
- For pain and discomfort, phenazopyridine (Pyridium) 100-200mg three times daily for 2-3 days can provide urinary tract analgesia, though patients should be warned about orange-red urine discoloration.
- Anti-inflammatory medications like ibuprofen 400-600mg every 6-8 hours can help reduce inflammation.
- Bladder antispasmodics such as oxybutynin 5mg twice daily or tolterodine 2mg twice daily may relieve urgency and frequency.
- Patients should increase fluid intake to 2-3 liters daily to dilute irritants in urine.
- Avoiding bladder irritants like caffeine, alcohol, spicy foods, and acidic beverages is recommended.
Intravesical Instillations
- Intravesical instillation of hyaluronic acid, as recommended by the most recent study 1, can improve symptoms of interstitial cystitis.
- Other intravesical agents such as dimethyl sulfoxide (DMSO) and pentosan polysulfate (PPS) may also be effective, as shown in studies 2 and 3.
Behavioral Interventions
- Patient education and support are critical in managing this complex but treatable disorder, as emphasized in study 4.
- Behavioral interventions such as bladder training and pelvic floor physical therapy may also be beneficial in reducing symptoms. If symptoms persist beyond 1-2 weeks despite symptomatic treatment, further evaluation is necessary to identify underlying causes, which may include cystoscopy, imaging studies, or referral to a urologist. Key points to consider when treating sterile cystitis include:
- Accurate and timely diagnosis
- Multimodal treatment approach
- Patient education and support
- Avoidance of bladder irritants
- Regular follow-up to monitor symptoms and adjust treatment as needed.