Electromotive Administration of Intravesical Lidocaine in Patients with Interstitial Cystitis

Abstract

Six patients with long-standing interstitial cystitis (IC) were treated with intravesical electromotive drug-assisted (EMDA) therapy using lidocaine (1.5%) and 1:100,000 epinephrine in aqueous solution. A stainless-steel silver-coated anode placed through an 18F Foley catheter was positioned in the urinary bladder, and a 5 x 10-cm dispersion electrode (cathode) was placed on the suprapubic skin, which was well lubricated with conductive jelly. The two electrodes were connected to a pulsed DC generator, and electrical current was slowly ramped from 0 to 15 mA while the lidocaine and epinephrine were in the urinary bladder. After 40 minutes of current application, the bladder was hydraulically dilated to maximum tolerance. Significant bladder dilatation was achieved without systemic symptoms. Post-treatment, voiding symptoms decreased, as did suprapubic and perineal pain, and in four patients, the results have been durable.

Transient ischemic attack after electromotive drug administration for chronic non‐infectious cystitis: Report of two similar cases

“…Except for mild symptoms associated with application of electrical current (tingling and erythema), no major side e¡ects have been observed [Gurpinar et al, 1996a;Riedl et al, 1997].…”

“…More recently, iontophoretic and electrophoretic drug delivery (electromotive drug administration, EMDA) have been utilized to allow for deep penetration of substances like lidocaine, dyes, mitomycin C, dexamethasone, and epinephrine into the bladder wall [Lugnani et al, 1993;Gurpinar et al, 1996a;Di Stasi et al, 1997;]. In experimental studies, dyes were found in the upper layers of the bladder muscle after EMDA therapy [Gurpinar et al, 1996b].…”

Thermo–Chemotherapy and Electromotive Drug Administration of Mitomycin C in Superficial Bladder Cancer Eradication

“…EMDA represents a new and attractive method for intravesical administration of several drugs [25, 26, 27]. This technique is based on several electrokinetic phenomena, mainly iontophoresis.…”

Beyond a Simple Anesthetic Effect: Lidocaine in the Diagnosis and Treatment of Interstitial Cystitis/bladder Pain Syndrome

“…Positive outcomes of bladder capacity, voiding frequency, and pain were also reported using EMDA lidocaine followed by cystodistension. [15][16][17] Although studies using intravesical EMDA have shown improved analgesia when used as an anesthetic for bladder procedures such as hydrodistension, capsaicin instillation, and bladder biopsies, absorption kinetic studies have not been published. 18,19 Alkalinization of intravesical lidocaine with sodium bicarbonate was first described in 1979 by Higson et al 20 They administered 40 mL of 1% lidocaine with 40 mL of 8.4% sodium bicarbonate, held in the bladder for 30 minutes, to 20 subjects with urinary frequency, urgency, and incontinence who were diagnosed with detrusor instability at that time.…”