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Interstitial Cystitis

Posts to Ask Dr Stoll BB regarding Interstitial Cystitis

There have been several posts to the Ask Dr Stoll
Bulletin Board (BB) regarding Interstitial
Cystitis.
Many of them have been archived here. The archive is roughly
chronological. I hope you find it useful.

Summary explanation for Interstitial Cystitis:

This condition, by conventional standards, has no known cause and no known cure. However, it has been known for more than 50 years that dilation of the urethra gives relief of symptoms for at least months and sometimes years. Now it is known, at least by biofeedback trainers, that dilation works because the basic cause is unconscious "bracing" of the levator ani muscle. This is only caused by stress-effect storage in the hypothalamus although, sometimes, it is at least contributed to by a symbolic tension of that muscle due to sexual inhibitions and sometimes due to pelvic congestion syndrome due to lack of orgasm with sexual stimulation. See the glossary for any unfamiliar terms.

The only known cure is to deal with the cause--as in all chronic conditions. If the cause is the most common one (bracing due to chronic stress-effect storage) the only known solution is the practice of skilled relaxation as described in the homepage article and in the ( Skilled Relaxation archive ). It would also be helpful to become a student of the effects of chronic stress-effect--see the homepage article, the glossary, search engine and archives about that to get started. If it is due to lack of orgasm, having an orgasm once a day for several weeks will resolve the problem for at least months---certainly more pleasant than a urethral dilation: see "For Yourself" by Lonnie Barbach.

The MECHANISM OF CAUSATION IS AS FOLLOWS:

There are two muscular sphincters at the base of the bladder that keeps one from leaking urine as fast as the kidney makes it. After all the purpose of the bladder is to store urine as it builds up until the person can pause to empty it. The top sphincter is made of smooth muscle (involuntary) just like the muscle of the wall of the bladder. When the bladder gets full enough to stretch the wall the smooth muscle sphincter automatically releases. This is when we normally feel the first urge to urinate.

However, humans also have that second sphincter and it is made of striated (voluntary) muscle just like all the other voluntary muscles in the body. SO, if it is not appropriate to just let loose right then, we contract that muscle until we can go to the bathroom. This is the muscle that children learn to control for toilet training and is part of the levator ani muscle which forms the sling that keeps all of our guts from falling out through the pelvis. This muscle makes up the bladder sphincter, vaginal sphincter & anal sphincter.

IF that muscle is always tense, we are unable to relax it completely (even when we want to) and the bladder muscle then has to squeeze a lot harder to force the urine past this obstruction. That forces some of the urine into the wall of the bladder and that produces inflammation. Since the bladder cannot totally empty itself, under these conditions, there is always a little residual and that contributes to frequency & the feeling of urgency while the inflammation causes most of the symptoms.

I have yet to see anyone who did not resolve this problem by practicing Skilled Relaxation, faithfully, for 6-12 months. In the meantime, conventional dilation, irrigation with DMSO or silver nitrate, tranquilizers, urinary analgesic medications, etc., should be continued for relief of symptoms.

For a specific biofeedback instrument to resolve this go to http://askwaltstollmd.com/cystitis.html.

If, after doing the reading above, anyone still has questions, put them on the bulletin board.

Those wanting testimonials as to how well this approach works, read on below.

Help others by sharing your experiences as you get well.

Walt Stoll, MD

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