Editing Interstitial cystitis (section)

===Bladder instillations===
Bladder instillation of medication is one of the main forms of treatment of interstitial cystitis, but evidence for its effectiveness is currently limited.<ref name=pmid23276554/> Advantages of this treatment approach include direct contact of the medication with the bladder and low systemic side effects due to poor absorption of the medication.<ref name="pmid23276554" /> Single medications or a mixture of medications are commonly used in bladder instillation preparations. [[Dimethyl sulfoxide|Dimethyl sulfoxide (DMSO)]] is the only approved bladder instillation for IC/BPS yet it is much less frequently used in urology clinics.<ref name="treatments">{{cite web |url=http://www.mayoclinic.com/health/interstitial-cystitis/DS00497/DSECTION=treatments-and-drugs |title=Treatments and drugs |year=2011 |publisher=Mayo Clinic |access-date=1 October 2012 |url-status=live |archive-url=https://web.archive.org/web/20121023044819/http://www.mayoclinic.com/health/interstitial-cystitis/DS00497/DSECTION=treatments%2Dand%2Ddrugs |archive-date=23 October 2012}}</ref>

The disadvantages of installations are severe pain in the urethra, caused by the catheter that is used to administer the instillation, bladder pain and the fact that most installations need to be held in the bladder for at least two hours, whereas some patients have to urinate (far) more frequent than once every two hours. This causes severe pain and/or affects the treatment because the instillation did not sit in the bladder long enough.

About DMSO:

50% solution of DMSO had the potential to create irreversible muscle contraction. However, a lesser solution of 25% was found to be reversible. Long-term use of DMSO is questionable, as its mechanism of action is not fully understood though DMSO is thought to inhibit mast cells and may have anti-inflammatory, muscle-relaxing, and analgesic effects.<ref name="pmid23276554" /><ref name="pmid19808225" /> Other agents used for bladder instillations to treat interstitial cystitis include: heparin, lidocaine, chondroitin sulfate, hyaluronic acid, pentosan polysulfate, [[oxybutynin]], and botulinum toxin A. Preliminary evidence suggests these agents are efficacious in reducing symptoms of interstitial cystitis, but further study with larger, randomized, controlled clinical trials is needed.<ref name="pmid23276554" />