Everything you need to know about hydrodistention 

Hydrodistention is a procedure that uses fluid to fill and “stretch” the bladder. If you have Interstitial Cystitis, also called Bladder Pain Syndrome (IC/BPS), this procedure may be recommended for your treatment. In addition to bladder pain, many patients with IC/BPS experience painful bladder filling and painful urgency. This causes them to go to the toilet very frequently in order to relieve the pain. As a result, even if their bladder was normal sized before their IC/BPS symptoms started, their bladders become functionally small. 

Hydrodistention could help restore functional bladder capacity. This means your doctor can see how much your bladder can physically hold versus the amount your bladder sensitivity allows you to hold. It may also help decrease the symptoms of chronic bladder pain, frequent urination, and painful urgency. Let’s take a closer look at this procedure and how it could be beneficial for IC/BPS symptoms.  

Hydrodistention, an overview. 

Hydrodistention is a medical procedure where the bladder is filled to its full capacity with sterile water or saline. This procedure is performed under anesthesia and is thought to serve multiple purposes in the context of IC/BPS. For instance, when a doctor is trying to find out what is causing bladder pain, they may perform a simultaneous cystoscopy with hydrodistention and  possibly a bladder biopsy. Doctors can use this to diagnose IC/BPS. 

In other cases, doctors may use hydrodistention to help with symptoms. During the procedure, the bladder is distended or stretched beyond its usual capacity before the solution is drained.  The idea is that overstretching the bladder helps reset the bladder nerves. 

The procedure, explained.   

Typically, hydrodistention should only last about thirty minutes. You will lie on your back with your legs in stirrups and be given a general anesthetic or intravenous sedation. The cystoscope, which is a thin tube with a small camera on one end, will be inserted into your urethra and your bladder. The doctor will use this to inspect your bladder walls.  

As your bladder fills, it expands. Once filled to its capacity, the fluid stays in your bladder for up to ten minutes. Then, it is drained and often repeated a second time Afterwards, your doctor will examine the bladder lining once more looking for changes consistent with IC/BPS. Your doctor may use this as a chance to take a few biopsies. 

The tube is removed and the procedure is completed. You may experience some bleeding from the bladder lining as it stretches. Usually, the bleeding is minimal and should stop before you go home. 

What to expect after bladder hydrodistention. 

After a hydrodistention, you can expect to stay in the recovery room for a short time before being discharged home. Some patients report feeling a strong urge to urinate and pelvic pressure, even though their bladders are empty. As mentioned above, some patients may experience bleeding. When discharged, your doctor may prescribe antibiotics and pain medication. 

Using hydrodistention for IC/BPS. 

Following a hydrodistention, most people have some discomfort. Your doctor usually prescribes pain medication. Most patients experience no change in their symptoms. For some, symptoms may even worsen for at least a few days before seeing improvement. It’s important to remember this procedure isn’t a cure for IC/BPS. Currently, there is no cure for the condition. Other IC/BPS patients may experience relief.  

When using hydrodistention for IC/BPS or other similar conditions, patients can expect the following:  

• Temporary relief of symptoms. Some people with IC/BPS report temporary relief from symptoms following hydrodistention. The stretching of the bladder during the procedure may disrupt nerve signals. This could help with the pain and discomfort in the bladder. Repeat procedures may be necessary to sustain the benefits, but most people who get relief usually do so for about six months 
• Increased bladder capacity. In some cases, hydrodistention may increase the amount of fluid the bladder can hold. Studies have even shown that when combined with bladder training, patients experienced even better results. This varies depending on the person.  
• Diagnostic tool. In addition to its therapeutic potential, hydrodistention is sometimes used as a diagnostic tool. This could mean answers for people needing a diagnosis. It also allows healthcare providers to assess the bladder lining and rule out other potential causes of symptoms. 

Hydrodistention is one of the few procedures for IC/BPS.  As our understanding of IC/BPS continues to evolve, so too will the approaches to managing and improving the lives of those affected by this challenging condition. 

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