Bladder Instillations

A bladder instillation, or wash, can assist in managing many different bladder problems.

Sometimes referred to as a bladder wash or bath, a bladder instillation is a treatment involving a solution inserted into the bladder through a catheter and released after a short period of time.

• One of the most common reasons a urologist may recommend instillations of the bladder is interstitial cystitis (IC), a chronic inflammation condition caused by nerve miscommunication that's sometimes mistaken for a urinary tract infection.
• IC isn't curable, although it's often manageable with bladder instillations in combination with other treatments.

Other Reasons for Bladder Instillations

In addition to IC, bladder washes may be a suggested treatment for patients with chronic UTIs, accumulated sediment in urine, or other conditions that reduce bladder capacity and contribute to frequent urination not caused by an underlying problem such as a tumor or enlarged prostate. Bladder baths may also help with issues related to blocked urinary catheters.

How Bladder Washes Are Done

During a bladder instillation, a solution is inserted into the bladder through a catheter. The solution, or "wash," remains in place for about 10 to 15 minutes before it's drained. The treatment can be done by a urologist or with self-catheterization at home.

Bladder Instillation Solutions

The only bladder instillation solution approved by the FDA is dimethyl sulfoxide (DMSO). It's believed that this solution works by increasing bladder capacity and relaxing pelvic and bladder muscles. The solution also passes through tissues in the bladder wall to help reduce inflammation and discomfort.

Potential side effects associated with DMSO are minimal, with one of the most common ones being a garlic-like odor that may continue for a few days after bladder baths. Some urologists add other medications such as Heparin, which may ease damage to the bladder lining, to DMSO solutions.

Treatment Frequency

Bladder instillations are typically done every week or every other week. The cycle of treatments usually continues for anywhere from a month or so to up to two months (6-8 weeks). Bladder baths may be repeated in multiple cycles if it's determined that the treatments are helping to control symptoms. Some patients take a break between treatments and start a cycle of instillations again if symptoms ease and return again later.

Results and Follow-Up Care

Results with bladder instillations will vary. However, many patients notice a reduction in symptoms within a month after starting the bladder wash treatment cycle. If the treatment is continued on a long-term basis, follow-up tests are usually done every six months. Testing typically includes a complete blood count (CBC), urine tests, and tests to check liver and kidney functions.

Patients with underlying bladder or urinary system issues may also have visual examinations done with a lighted scope with a camera attached (cystoscope). Since bladder instillations require catheter use, patients are sometimes examined and tested for urinary tract infections.

Bladder instillations may be more effective when combined with changes to exercise and diet habits. This includes staying away from acidic and spicy foods that may irritate the bladder, minimizing alcohol consumption, and exploring gentle forms of exercise. Some patients also benefit from pelvic floor exercises, bladder training, Botox injections, medications that relax bladder muscles, and electrical stimulation techniques like TENS (transcutaneous electrical nerve stimulation).