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Interstitial Cystitis
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Interstitial Cystitis (IC) is a chronic bladder inflammatory condition of unknown cause. At present there is no cure for IC and treatment is aimed at alleviating the symptoms. Dimethyl Sulphoxide (DMSO) is known to relieve the symptoms for some people.
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The initial course of treatment involves bi-weekly bladder instillations for four weeks followed by weekly instillations for four weeks. (Total 12 treatments / 8 weeks)
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A subsequent or "top up" course of treatment usually involves weekly instillations for four weeks. (Total 4 treatments / 4 weeks)
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Responsibilities
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Medical officer
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- diagnosis and referral to Urogynaecology Nurse to arrange course of treatment (as an out patient), and facilitate any necessary communication
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- obtaining informed consent for the administration of DMSO and
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- prescribing the course of treatment. (DMSO 50% in Bupivicaine 0.1% X 50 mLs, Heparin 5,000 units, Hydrocortisone 100mgs per instillation)
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Nursing staff
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- liaison with the patient to arrange appointments and provide appropriate information
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- make appointments with Out Patients department (Urogynae Template/ Cont Adv/DMSO) Appointments are available on Monday and Thursday afternoons only
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- arrange a follow up Out Patient appointment 8 weeks after the last treatment with Urogynaecology
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- notify pharmacy (with script) at least 4 working days prior to the first treatment
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Administration of DMSO solution
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The solution is instilled into an empty bladder using a sterile intermittent catheterization technique.
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- Prior to the instillation, test residual urine for signs of infection.
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- Care must be taken when mixing and instilling the solutions, appropriate protective gear should be worn (goggles, mask, long sleeved gown).
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- Instill the solution into an empty bladder, remove the catheter and leave the solution in the bladder for 20 minutes. After 20 mins the solution should be voided into a toilet.
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Patient comfort
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- oral analgesia may be taken prior to administration
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- the medication may cause transient bladder irritability
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- some people develop a garlic type odour for 24- 48 hours after each treatment.
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Royal Women's Hospital Clinical Practice Guidelines (CPGs) are intended to provide guidance to health care professionals, based on a thorough evaluation of research evidence, on the practical assessment and management of specific clinical issues or situations. The guidelines allow some flexibility on the part of the health care professional based on the needs of the specific patient for whom they are caring.
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