Cystitis in women: what your doctor can do
Antibiotics
Your doctor can prescribe an antibiotic (such as nitrofurantoin or trimethoprim) if bacterial cystitis seems likely. Cure rates with antibiotics are about 85–95%. Most women are not keen on taking too many antibiotics, so one possibility is to wait for 48 hours and see if the symptoms clear up; if not, take the antibiotics. This may mean that you have the discomfort for longer (see what you can do to relieve the symptoms of cystitis), but on the other hand you may be able to avoid taking an antibiotic (British Medical Journal 2010;340:b5633).
Checking your urine for bacteria
Painful bladder syndrome
- Amitriptyline and similar drugs are often used (Journal of Urology 2005;174:1837–40). These drugs are commonly used antidepressants, but they also have a pain-blocking effect. In interstitial cystitis, they are used as a pain blocker, not because your doctor thinks you are depressed or imagining your symptoms.
- Antihistamine medications (similar to hayfever treatments) have been tried, on the basis that interstitial cystitis might be a type of allergy.
- Pentosan polysulfate is used in the USA and in some other countries, but is not available in the UK. It contains the glucosaminoglycans chemicals that some researchers think are deficient in the bladders of women with interstitial cystitis. It may take up to 6 months before it has any effect. Some scientific studies to assess whether it works have been encouraging; other have given contradictory results.
- ‘Hydrodistension’ is stretching of the bladder with water. This is a specialist treatment and you would need an anaesthetic. No one knows how it works, but it helps 60% of people. The improvement lasts for several months.
- DMSO (dimethyl sulfoxide) can be squirted into the bladder to reduce pain and inflammation. Some studies suggest that it works in about 50% of people, but these studies may not be reliable because they involved only small numbers of people (British Medical Journal 2008;337:a2325). For this treatment, you will need to be referred to a specialist. There have been worries that DMSO could affect the eyes and liver.
- Low doses of prednisolone (a steroid) or ciclosporin have been used to reduce bladder inflammation if other treatments have not worked (British Medical Journal 2009;339:b2707). More research needs to be done on these medications.
Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated:
Thursday, May 17th 2012
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Cystitis in women: what your doctor can do
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Fascinating facts
Every year, 1–3 women out of 10 have an attack of cystitis
At any time, about 1 in 20 healthy women has bacteria in her bladder, without any symptoms. Only 10% of these progress to cystitis symptoms
In the USA, over 11 million women each year receive antibiotics for cystitis, costing over $1.6 billion (£1100 million)
In the UK, doctors write 5.5 million prescriptions for cystitis each year
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