Bladder instillations are also referred to as bladder washes or baths.
When working properly, the bladder is a highly efficient urinary system organ that facilitates the removal of urine from the body with precise muscle contractions. Yet there are times when the bladder may be affected by conditions such as interstitial cystitis (IC), a sometimes painful inflammatory disease that affects the bladder lining. An incurable condition, IC can increase urination frequency and produce general discomfort in the pelvic and genital area. This is one of the common reasons why a urologist might recommend bladder instillations.
In addition to conditions like interstitial cystitis, bladder instillations may be done if there is sediment detected in a urine sample or urinalysis. Bladder baths may also be helpful if you are experiencing recurring urinary tract infections not related to underlying issues such as kidney or bladder stones, an enlarged prostate, or blockages, or limited bladder capacity that’s contributing to frequent urination.
Before Bladder Washes Are Recommended
Prior to recommending and beginning bladder washes, a urologist usually performs a pelvic exam and urine and blood tests. Additional testing may include an examination of cells referred to as cytology and/or a biopsy to rule out cancer and a visual inspection of the bladder with a lighted scope (cystoscopy). A potassium sensitivity test is sometimes done to gauge the level of discomfort and urge to urinate by placing a water and potassium chloride solution into the bladder.
How Bladder Baths Are Done
During an instillation treatment, a solution is inserted into the bladder through a urinary catheter. It’s usually left in place for about 10 to 15 minutes before being expelled through the catheter. When performed as an in-office treatment, bladder instillations are typically done every week or every other week for a few months.
The Food and Drug Administration has only approved dimethyl sulfoxide (DMSO) for use as a solution in bladder instillations. It’s believed DMSO works by relaxing muscles in the pelvic area and ones that affect bladder contractions. Other medications are sometimes added to DMSO to minimize possible issues with damage to bladder lining that sometimes occurs with DMSO solutions. A newer way to prepare solutions is to use a mixture that includes sodium bicarbonate, lidocaine, and heparin or pentosan polysulfate.
If interstitial cystitis is the reason why bladder instillations are being recommended, a urologist might suggest additional treatments between bladder washes to manage symptoms. Other treatments may also be recommended if underlying issues are contributing to bladder irritations or control problems. Possible complementary treatments and management options include:
Oral medications that may include NSAIDs (anti-inflammatory drugs) and antidepressants
Stretching the bladder with water (bladder distention)
If bladder instillations are effective, another cycle of treatments may be recommended. It is possible to safely perform bladder washes at home. However, some patients, especially individuals not comfortable with self-catheterization, prefer to have a urologist complete the process. Another benefit of in-office bladder baths is the ability to have the bladder examined to check for other issues in the urinary system if there’s a point where instillations are no longer significantly easing symptoms and improving comfort.