bladder cysts

I have had one or two bladder infections yearly for the past 25 years.  I did not know that I had a dropped bladder until about 8 years ago (no incontinence).  After doing considerable research, I discovered that my infections occurred whenever I ingested acid food or drink.  I was then able to control the infections to some degree.  I had a bladder suspension three and one-half years ago.  I began using Premarin cream at my doctor's insistence after the surgery and two years ago began taking Fosamax.  My internist had given me Premarin tablets many years ago, and I had constant bladder burning and had to quit taking them. I had no apparent trouble with either the cream or the Fosamax this time.  However, I developed bladder pain (mild but constant) about 8 months ago, and my urologist gave me cipro which seemed to cure it, although tests were negative for an infection.  Four months ago the same pain began and after testing for cystitis was repeatedly negative, I was cystoscoped and found to have bladder cysts.  The doctor said they looked like freckles.  He gave me antibiotics for about l2 days which helped but did not totally stop the discomfort.  He then suggested that I more or less wait it out.  I did get better, but almost every time I eat out at a restaurant, I have another painful reaction.  I have pinpointed chicken particularly as I believe it is frequently marinated in acid.  I have had to stop eating anyone's cooking but my own.  I stopped both the Premarin and Fosamax as I had a severe bladder burning reaction from the Premarin  cream shortly after my diagnosis, and I believe one or both caused these cysts.  I was cystoscoped four years ago by the same doctor, and nothing was found.  I have been unable to find any information on the internet and would appreciate your suggestions.  I feel there must be some relief for this condition.  I  am concerned, of course, that it will develop into something even more severe.

[Kevin Pho, MD]

One consideration would be interstitial cystitis (IC).  THis refers to a clinical syndrome characterized by chronic urinary urgency/frequency and/or pelvic pain.

You already have had a cystoscopy and I am assuming routine urine tests to rule out most of the major diseases.  The intravesical Potassium Sensitivity Test (PST) tests for abnormal urothelial permeability, which is present in many individuals who have IC.

If IC is confirmed, there are various options that you can discuss with your urologist.  This can include:

Heparinoid therapy is administered to all patients to restore epithelial function in the lower urinary tract

Tricyclic antidepressants can be used to inhibit the neural activation that accompanies the disease, particularly in the individual who has long-standing symptoms

Antihistamine therapy can be used to control allergies that may aggravate IC.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

Bibliography:
Parsons.  Interstitial cystitis.  UptoDate, 2004.

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