Can bladder inflammation be treated

[cnstrish]

In 1971, follwing a dysenteric bowel infection, my husband  was diagnosed with Reiters Syndrome of the polyarthritis variety. Around 1990 he developed UTI symptoms but antibiotic treatment did not help. A cystoscopy followed and inflammation of the bladder was apparent. The prostate was not enlarged but even so the urologist decided to remove the prostate to 'improve the outflow'. I am a registered nurse but at the time there was little knowledge about Reiters Syndrome available to me but even so I suggested to the surgeon that as this was an inflammatory condition, this may be related. My idea was dismissed. The surgery seemed to make matters worse, A course of extremely painful bladder washouts followed ( my husband described the after effects to be like passing broken glass) and when this
failed more surgery to widen the bladder neck was tried. The urologist retired and a second urologist also dismissed my thoughts on the association with Reiters, did a further cystocopy, reported on inflammation but prescribed no treatment. My husband is now 72 and is otherwise fit and active but his life and our social life is blighted by this bladder condition which also sees him getting up 4 to 8 times nightly. Our daughter is to marry soon and he is concerned that he may not be able to get through the ceremony with out problem. He also suffers skin rashes and irritating spots on the soles of his feet from time to time.  He has also been left with an ankle that was so badly affected by the original episode in 1971 that he underwent arthrodesis. He suffers from occasional inflammation of joints affecting his neck, back and hands. It is only my recent use of the web that I have been able to confirm my own gut feelings that my husband bladder condition may be related to Reiters. Was surgery the correct treatment for this condition and is there anything that we can do, at this late stage to ease these very troubling symptoms?

[Stephen Liroff, MD]

I am not clear as to what symptoms your husband has. Does he have urgency to urinate and frequency of urination? Burning with urination? Pelvic pain? Has he had a urodynamic evaluation to learn about his bladder function? This can be done with fluoroscopy to gain some anatomic information in addition to functional info. I would also suggest a current cystoscopy. Without the information from these tests combined with his symptoms we are just guessing about treatment.
To get back to your initial question, I think that most likely he can be helped, but we need more information. You might seek the care of a urologist who specializes in interstitial cystitis and also a rheumatologist as regards his rashes and pedal "spots."
S.A.Liroff, M.D.

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