Dr. Christian Reutter of our Manhattan, NY office location talks about the signs and symptoms of interstitial cystitis in males and how it can be treated at Pelvic Rehabilitation Medicine.
Dr. T. R. Christian Reutter received his BA from The Johns Hopkins University, attended medical school at the University of Health Sciences College of Osteopathic Medicine in Kansas City Missouri, and then completed his residency in Physical Medicine and Rehabilitation at the University of Texas Health Science Center in San Antonio, Texas. He practiced for almost 17 years as a sports medicine and spine specialist in San Francisco, California before joining the Pelvic Rehabilitation Medicine team in New York.
At Pelvic Rehabilitation Medicine, our pelvic pain specialists provide a functional, rehab approach to pelvic pain. When you visit one of our offices, you spend an hour with your doctor reviewing in detail your medical history and symptoms. Then, we perform an internal exam (no speculum) to evaluate your nerves and muscles. Together, we'll discuss an individual treatment plan that gets to the root cause of your pain and helps you to feel better. The best part: you can begin treatment the same day!
At PRM, our mission is to decrease the time patients are suffering from pelvic pain symptoms.
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The definition of interstitial cystitis is a sense of bladder pressure or pain and the need to urinate frequently. So the cause of painful bladder syndrome in males is not quite known. It's thought that there's a break in the lining of the bladder, called the epithelium. This results in the leak of harmful materials from urine. This causes the bladder lining to become irritated and painful. Risk factors for painful bladder syndrome include recurrent urinary tract infections, irritable bowel syndrome, age over 30, and chronic pain conditions, which include things like fibromyalgia.
So with regard interstitial cystitis, it's always recommended to see a urologist first for appropriate workup. You want to rule out infection. Often a cystoscopy is done. Cystoscopy actually involves insertion of a tube with a camera at the end through the urethra into the bladder. And this actually looks at the bladder wall and the urethral lining. With interstitial cystitis, the cystoscopy will actually pick up what are called hunters lesions, which essentially ulcers in the lining of the bladder wall. Whereas with painful bladder syndrome, you will not see the ulcers.
So treatment is actually includes multiple modalities, like physical therapy to address pelvic floor hypertonia, injections to actually address pelvic floor muscle spasm, as well as nerve irritation, medications like antidepressants, which are actually given to decrease pain, antihistamine medications to decrease irritation and pain, even medications like Elmiron, which is thought to line the wall of the bladder and actually prevent leakage and irritation. We also include things like bladder installations, which is the insertion of a medical fluid into the bladder to help actually calm down the irritation. And in some cases we would consider surgery. Surgical procedures can include things like expanding the bladder as well as removing the ulcers in the bladder wall.
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