Minimally invasive device for intravesical instillation by urological syringe adapter (MID-ii U.S.A.) for catheter-free instillation therapy of the bladder in interstitial cystitis/bladder pain syndrome.

The intravesical instillation of bladder cocktails via catheter is a widely spread, most effective way of treatment of interstitial cystitis/bladder pain syndrome. This disease often affects the urethra too, causing tenderness and pain. Therefore, catheterization causing superficial mucosal lesions triggers strong and long-lasting pain, sometimes bleeding, and a higher risk of infection.

We invented an adapter fitting on both Luer-lock and Luer-slip syringes allowing the injection of "bladder cocktails" into the bladder through the urethra in a retrograde way; the injected fluid opens the bladder sphincter. Its radiused tip and the specially shaped flexible isolating collar allow us to perform drop-free instillation without catheterization. In the last 2 years, clinical evaluations were conducted in 270 interstitial cystitis/bladder pain syndrome patients (243 female, 27 male), altogether totalling 1520 instillations.

In 5 of 243 female patients (2%) using the syringe adapter was unsuccessful due to the deep located urethral orifice or cicatricose vaginal opening. This made visualization of the urethral orifice impossible (success rate: 98%). All the 27 male patients (100%) could be treated without any difficulties. No infection due to the instillation was observed. All treatable patients preferred the catheter-free method to conventional catheterization. They did not report any pain, long-lasting burning sensation or any other complications.

The new non-invasive instillation method prevents superficial lesions of the urethra and treats urethral and bladder mucosa simultaneously. It reduces pain and the complication rate compared to conventional catheterization and at the same time reduces time, costs and inconvenience of bladder instillation.

International journal of urology : official journal of the Japanese Urological Association. 2019 Jun [Epub]

Sandor Lovasz

Rozsakert Medical Center, Budapest, Hungary.

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