Capsaicin

Posted by Marty on June 23, 1999 at 12:25:18
I have a neurogenic bladder with DESD due to a t-12 injury.  I have tried
both Ditropan and Detrol to reduce my bladder spasms and increase capacity;
neither drug has worked.  Recently I was advised by a urologist who specializes
in neurogenic bladders to undergo a procedure in which capsaicin is injected
into my bladder.  I have been told that this procedure should lessen the spasms
and increase capacity.  What is your opinion on capsaicin?  How safe?  How
effective?  How long do the effects generally last?
                                                  Thanks for your opinion,
                                                  It is greatly appreciated!                                                      

Posted by HFHS M.D.-AK on June 24, 1999 at 13:37:04
Dear Marty,
I have personally never used Capsaicin to treat a patient but have read about it in the literature.  Capsaicin decreases the afferent input peripherally which would be the ideal type treatment for your problem.  This compound helps treat sensory urgency, bladder instability, and in your case, hyperreflexia.  Capsaicin is an irritant and algogenic compound obtained from hot red peppers.  It has highly selective effects on a subset of mammalian sensory neurons.  Local or topical administration  of this compound blocks C-fiber conduction(Sensory fibers) thereby reducing perceived pain and inflammation.  Intravesical administration carries all the advantages of therapy without the potential systemic side effects.  After therapy, there is immediate suprapubic burning for 10 minutes.  The systemic symptoms begin to disappear on day 2-3 and remain completely treated for up to 3 weeks.  At this point, the symptoms gradually reappear but never reach the level of the initial problem.  Also, the bladder capacity increases and decreases frequency of urination.
I think the treatment itself is very safe, and there should be no long-term side effects.  You will have to have a catheter inserted into the bladder potentially introducing an infection.  Again I don