Symptoms in patients with interstitial cystitis fluctuate greatly, with symptoms, objective findings, and response to treatment varying greatly from patient to patient and, in the same patient, at different times. Practice has also found that electrical stimulation therapy is effective in interstitial cystitis. The above proves that neurological disorders have a role in the pathogenesis of interstitial cystitis. Therefore, neuromodulation has recently become a major treatment for interstitial cystitis with good results.
The main therapeutic tools: i. RTX bladder perfusion. The bladder afferent pathway is composed of myelinated Aδ fibers and unmyelinated C fibers, where C fiber neurons have dual functions: i) sensory afferent function; ii) local release of substance P, neuropeptide A, calcitonin gene-related peptide (CGRP) and other neuropeptides. rtx (Resiniferatoxin) is a stimulant from a cactus-like RTX desensitizes afferent neurons, inhibits afferent C-fibers, and causes a decrease in the density of C-fibers in the subepithelial tissue of the bladder.
Peripheral nerve electrical stimulation can be used percutaneously, transvaginally, or transrectally. The main purpose is to electrically stimulate the myelinated afferent nerves and activate the segmental inhibition loop, which can inconveniently block pain afferents and reduce the symptoms of urinary frequency. Currently used to treat interstitial cystitis, also achieved significant results, in addition to a significant improvement in urinary frequency and urgency, bladder pain relief is more obvious. s3 is the most commonly used site of electrical stimulation.
Fourth, posterior tibial nerve electrical stimulation posterior tibial nerve electrical stimulation is effective, simpler and less expensive for various lower urinary tract symptoms. It is suggested that it may also be effective in interstitial cystitis, and its effectiveness is still waiting to be proven in clinical practice.