title: Treatment of interstitial cystitis/painful bladder syndrome as a neuropathic pain condition.
abstract: 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.
authors.affiliation: Department of Neuropathic Pain, Ashirvad Institute of Pain Management and Research, Mumbai, Maharashtra, India.
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Vas
authors.affiliation: Department of Neuropathic Pain, Ashirvad Institute of Pain Management and Research, Mumbai, Maharashtra, India.
authors.forename: Manorama
authors.initials: M
authors.lastname: Pattanik
authors.affiliation: Department of Neuropathic Pain, Ashirvad Institute of Pain Management and Research, Mumbai, Maharashtra, India.
authors.forename: Vaishali
authors.initials: V
authors.lastname: Titarmore
keywords: Botox injection into pelvic floor muscles; caudal epidural analgesia; interstitial cystitis; painful bladder syndrome
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