Conventional Treatments

Analgesics

If pain is the issue, one of the easiest things you can try is the OTC Azo Bladder Pain Relief Tablets . Azo is the OTC version of Pyridium, the medication best known for turning urine orange. It helps by numbing the surface of the bladder and, to a lesser extent, the urethra. Uribel, a newer medication, also has a numbing effect.

Hormone Therapy

If women struggling with urethral syndrome demonstrate estrogen atrophy, dryness and sensitivity on the vulva and in the vagina, it’s quite possible that the urethra is also effected. In perimenopausal and menopausal women with dry, sensitive skin, the use of a simple estrogen cream can help strengthen the tissues and mucus layer. Women may be instructed to use the cream vaginally, on the vulva and at the entrance to the urethra.

Infection Treatment

If infection is found, traditional antibiotic therapy may be ineffective. Why? In the urethra, infection & bacteria are commonly found in the para-urethral gland where researchers have found many diverse types of infections living within bacterial biofilms. As a result of the protection that biofilms offer, antibiotics may be ineffective. Some urologists may massage the gland to express fluid that can be cultured. This will help to identify the type of infection present. They can also perform antibiotic sensitivity testing to determine the most effective antibiotic to treat that specific infection.

Antispasmodics

Antispasmodic medications (i.e. Ditropan, Detrol, etc.) can help reduce bladder spasms.

Muscle Relaxants

If pelvic floor dysfunction and muscle dysfunction is present, the use of a muscle relaxant may be helpful. It’s essential, though, that patients not rely just on medication to reduce muscle tension. A good physical therapy program can help patients learn how to reduce muscle tension without relying on medication.

Other Medications

Antidepressants and alpha-blockers have been helpful at reducing discomfort and improving urination in some patients.

Surgical Interventions

Urethral Dilation

Urethral dilations are now RARELY used unless a severe urethral stricture is preventing urination. For many years, however, urethral dilations were commonly used as a treatment. In 2015, most of the urology community considers dilations archaic and unnecessary unless the patient is unable to empty their bladder. One unnamed urologist at the AUA 2013 meeting was asked about performing urethral dilations for urinary symptoms. He responded “I don’t believe in raping the urethra.” Enough said.

Neuromodulation

A Step Four treatment option for interstitial cystitis, neuromodulation uses a mild electronic impulse to stimulate nerves that control urinary frequency and urgency. Two forms of neuromodulation are currently available: Urgent PC and Interstim. Urgent PC requires no surgery, is less invasive and associated with very few adverse events. Interstim is known as sacral nerve stimulation and though popular has hundreds of serious adverse events on file with the US FDA. It can require multiple surgeries, is quite expensive and