A CASE OF INTERSTITIAL CYSTITIS TREATED SUCCESSFULLY WITH STEROID AND BLADDER DISTENSION UNDER SACRAL NERVE BLOCK

Abstract

A case of interstitial cystitis treated successfully with steroid and bladder distension is reported.
A 53 years old male was admitted to our departemt with complaints of pollakisuria and pain on bladder region.
Histological examination by cystopunchbiopsy revealed epithelial erosion and submucosal nonspecific fibrosis. Cystography revealed an extremely low bladder capacity and bilateral VUR. After differential diagnosis, the patient was diagnosed as interstitial cystitis.
At first, antibiotics were administered intravenously bacause of concomitant urinary tract infection. However, severe symptoms continued after infection disappeared. Then we started steroid therapy and bladder distension by instillation of saline with antibiotics from an indwelling Foley catheter. Because of the existence of VUR, bladder instillation was performed at a capacity of 100-150ml and the bladder was inflated moderately. Increasing the instillation capacity gradually, bladder distension was performed every day with steroid therapy.
About 40 days thereafter, the bladder was inflated to the normal capacity and the pain disappered Then the Foley catheter was removed.
After removal of the Foley catheter, the patient showed no symptoms and was discharged.