Painful bladder condition relieved by lidocaine

People with a bladder condition called interstitial cystitis can find immediate relief with a solution developed by a doctor at the University of California, San Diego.

A combination of heparin, lidocaine and bicarbonate instilled into the bladder immediately reduces symptoms of urgency and pain, and can tide a patient over during the months until traditional heparin-based treatment reaches its full effect, Dr. C. Lowell Parsons notes in the January issue of Urology.

The results come from a trial involving 82 patients with newly diagnosed interstitial cystitis, who were treated with the alkalinized lidocaine-heparin solution. The sodium bicarbonate aids the absorption of lidocaine, Parsons explains.

Significant symptom relief was reported within 20 minutes of administration by 35 of 47 patients treated with 1% lidocaine and by 33 of 35 treated with 2% lidocaine, according to Parsons' report.

Among the patients who received the higher dose, 50 percent had at least 4 hours of relief from a single instillation, and several had relief lasting as long as 48 hours. Of 20 patients who elected to receive additional instillations, 16 had sustained significant relief after 2 weeks of treatment.

"The 1% lidocaine solution should be tried first," Parsons advises. If it doesn't work, it's safe to go to 2% concentration.

"Because it produces symptom relief for hours beyond the period of immediate anesthetic effect of the lidocaine, the solution appears to downregulate bladder sensory nerves past the actual anesthetic period and thus may accelerate the recovery of the bladder," Parsons writes.

"The development of this solution," Parsons concludes, "may represent a significant advance both in the treatment of interstitial cystitis and in the understanding of the downregulation of sensory nerves."

SOURCE: Urology, January 2005.