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.
Written by:
Vas L, Pattanik M, Titarmore V. Are you the author?
Department of Neuropathic Pain, Ashirvad Institute of Pain Management and Research, Mumbai, Maharashtra, India.
Reference: Indian J Urol. 2014 Jul;30(3):350-3.
doi: 10.4103/0970-1591.128513
PubMed Abstract
PMID: 25097327
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