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

Abstract

Objective 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. Methods 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. Results 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. Conclusions 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.

GAG replenishment therapy for bladder pain syndrome/interstitial cystitis

“…It may also avoid the negative side effects of catheterization. A minimally‐invasive device for intravesical instillation, a urological syringe adaptor that fits on Luer‐lock and Luer‐slip syringes, has been developed and refined for use by both men and women …”

Preparation and characterization of a novel composite acellular matrix/hyaluronic acid thermosensitive hydrogel for interstitial cystitis/bladder pain syndrome

“…Intravesical instillation of HA requires the use of a catheter, but any catheterization procedure has the known risk of side effects, such as microscopic or visual damage to the urinary mucosa, and catheterization allows bacteria to be brought into the bladder from outside the body and adhere to the urethra over time, leading to pain, bleeding and a higher risk of infection. 65,66 Although the use of temperaturesensitive hydrogels has improved the efficacy of HA by prolonging its residence time in the bladder lumen, it has also somewhat disrupted the physical mechanism of urinary flushing to prevent urinary tract infections, leading to increased infection risk, which is a possible side effect that makes the adhesive properties of hydrogels a doubleedged sword. It has been shown that HA hydrogels have antibacterial properties.…”

Management of urinary tract infections in the era of antimicrobial resistance

“…It can be attached to Luer Lock or Luer Slip syringes and offers an efficient method of administering medicine into the bladder without needing a catheter. The adapter tip can be guided into the urethral orifice of female and male patients with minimal risk of pain or other complications ( 53 ).…”

“…It can be attached to Luer Lock or Luer Slip syringes and offers an efficient method of administering medicine into the bladder without needing a catheter. The adapter tip can be guided into the urethral orifice of female and male patients with minimal risk of pain or other complications (53). After an initial learning curve involving some practice with the Ialuadapter®, the use of the device for the instillation of HA and CS is a pain-free alternative to standard catheterization in both men and women, associated with fewer infections while providing simultaneous treatment of the bladder and the urethra.…”