Bladder problem solving.

Interstitial cystitis is an uncommon bladder disease diagnosed more often in women than in men. Its symptoms are pain and a frequent and urgent need to urinate, but unlike the more common bacterially induced cystitis, says urologist Edward Messing of the University of Wisconsin in Madison, its cause "is completely unknown at this time." A battery of treatments have been tried with little success.

In the past the chronic condition has been ascribed to emotional stress, but urologists now suspect a physiological cause. Researchers who believe the problems arise from the destruction of a protective mucous coating in the bladder have had some success using treatments that restore the lining. C. Lowell Parsons of the University of California at San Diego has used an anticoagulant that coasts the bladder wall, and at the recent American Urololgical Association (AUA) meeting in Atlanta, Larrian Gillespire, who runs an interstitial cystitis clinic in the Los Angeles area, reported positive results with a three-drug regimen.

In initial trials using the anticoagulant on 24 people, Parsons found that 22 experienced a significant decrease in pain. At the AUA meeting, he described successful use of the drug, not yet approved for use in the United States, in five patients with a similar type of cystitis induced by radiation given to treat cervical carcinoma.

Gillespie believes damage to the mucous layer from bacteria, antibiotics, hormonal changes or surgery can cause interstitial cystitis by allowing urine to interact with bladder wall cells. She uses a combination of an anti-inflammatory drug, an alkaline agent to counteract the urine's acidity, and DMSO to carry the drugs into the cells. Of 145 patients treated, 108 became symptom free and another 21 achieved relief after receiving additional medication to block pain receptors.

Gillespie's therapy needs to be compared with a placebo, sustantiated and reproduced before it can be considered a cure, cautions Messing.