CYSTICURE

Ozonated glycerin bladder instillations are a form of intravesical ozone therapy, where medical-grade ozone is introduced directly into the bladder. This approach is gaining interest as a treatment for various bladder conditions, especially when conventional therapies have not been effective.

How Urinary Tract Infections Can Develop Into IC

One study found that 74% of females diagnosed with Interstitial Cystitis had previously been diagnosed with recurrent UTIs. So what exactly is going on inside your bladder? Why don’t the UTI antibiotics work and why can recurrent UTIs result in a diagnosis of IC? There is a potential culprit here, so let’s take a closer look.

Chronic Embedded Infection

It’s quite possible that what you have considered to be separate UTIs or IC, is actually caused by an infection embedded in your bladder wall, that never completely goes away. The symptoms may come and go, or maybe you’ve reached the point where you have symptoms 24 hours a day. It’s different for everyone. A chronic, embedded infection like this is caused by a biofilm and/or by pathogens living within your bladder wall Your body naturally flushes out free-floating pathogens in your urine, but biofilms and pathogens within the bladder wall remain intact. Biofilms and intracellular communities make diagnosis and treatment very difficult. When the body recognizes a biofilm or intracellular community as a threat, it may begin to slough off pieces of the bladder wall, in an attempt to rid the bladder of these persistent pathogens. Many people describe seeing what appears to be tiny, tissue paper like pieces in their urine. It’s likely these are actually tiny pieces of your bladder wall. This can be a good sign, as it means your body is trying to eliminate the infection. You may experience the biofilm phenomenon as a cycle of acute symptoms, followed by periods of fewer or no symptoms. This is because bacteria or other pathogens are periodically released or escape from the biofilm, causing an inflammatory response which heightens the symptoms of a UTI. For IC sufferers, these periods may be experienced as flare ups, or it may feel as though you suddenly have a ‘real UTI on top of your IC.  If your symptoms are actually caused by a chronic infection, you may have an opportunity to pursue Interstitial Cystitis treatment, rather than symptoms management alone

Benefits of Ozonated Glycerin Bladder Instillations:

The benefits of ozonated glycerin bladder instillations are largely attributed to the properties of ozone itself, which include:

• Antimicrobial Activity: Ozone is a powerful oxidizing agent that can directly destroy the membranes of bacteria, viruses, and fungi, and inhibit biofilm formation. This makes it potentially effective against chronic bladder infections, recurrent UTIs, and fungal infections.

• Anti-inflammatory Effects: Ozone can reduce inflammation by downregulating pro-inflammatory factors and modulating cytokine secretion. This is particularly beneficial for conditions like Interstitial Cystitis (IC)/Bladder Pain Syndrome (BPS), where chronic inflammation is a key component.

• Immunomodulatory Effects: Ozone can stimulate the immune system, enhancing the activity of immune cells and improving the body's ability to fight infections. It can also help normalize cellular and humoral immunity.

• Regenerative and Healing Properties: Ozone may promote tissue regeneration and healing by stimulating antioxidant and anti-inflammatory responses, and activating fibroblasts. This can be helpful for damaged bladder lining.

• Pain Reduction: The pain-relieving action of ozone is linked to its anti-inflammatory processes and modulation of pain receptors.

• Reduced Antibiotic Reliance: For chronic infections, ozonated glycerin can potentially reduce the need for long-term antibiotic use, thereby lessening the risk of antibiotic resistance and preserving the natural microbiota.

• Direct and Prolonged Contact: The gel formulation of ozonated glycerin allows for direct and more prolonged contact of ozone with the bladder lining, potentially enhancing its therapeutic effects.

Actions of Ozonated Glycerin Bladder Instillations:

When ozonated glycerin is instilled into the bladder, the ozone reacts with the biological components within the bladder, leading to a cascade of effects:

1. Oxidation: Ozone directly oxidizes phospholipids and lipoproteins in microbial cell membranes, leading to their destruction. It also reacts with cytoplasmic substances, including DNA, disrupting bacterial proliferation.

2. Generation of Reactive Oxygen Species (ROS): Ozone reacts to form secondary messengers, including hydrogen peroxide (H2O2). In appropriate, low doses, this induces moderate oxidative stress, which, paradoxically, stimulates the body's own antioxidant defense mechanisms.

3. Modulation of Cellular Pathways: The induced moderate oxidative stress can activate beneficial cellular pathways, such as the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway, which plays a crucial role in antioxidant and anti-inflammatory responses.

4. Disruption of Biofilms: Ozone directly acts on biofilms, which are protective communities of microorganisms, potentially disrupting their barriers and making them more susceptible to the ozone's effects.

5. Improved Microcirculation and Oxygenation: While directly instilled into the bladder, the localized effects can include improved microcirculation and oxygen utilization in the bladder tissues, which can aid healing.

How it is Performed (General Procedure for Bladder Instillations):

While specific protocols may vary, the general procedure for bladder instillations, including those with ozonated glycerin, typically involves:

1. Preparation: The patient may be asked to empty their bladder before the procedure. The urethral opening is often wiped with an antiseptic.

2. Catheter Insertion: A small, flexible catheter is gently inserted into the bladder through the urethra.

3. Instillation: The ozonated glycerin solution (or other therapeutic agent) is instilled into the bladder through the catheter.

4. Catheter Removal: Once the solution is instilled, the catheter is removed.

5. Retention Time: Patients are usually asked to retain the solution in their bladder for a specified period (e.g., 30 minutes to a few hours) to allow for sufficient contact time.

6. Voiding: After the recommended retention time, the patient can void naturally.

Treatment frequency and duration vary depending on the condition being treated and the patient's response. For conditions like interstitial cystitis, sessions might be once weekly for a few weeks.

Potential Side Effects:

Side effects associated with bladder instillations, including those with ozonated glycerin, are generally minimal and primarily related to the catheterization process itself:

• Discomfort or Pain: Some discomfort, irritation, or a stinging sensation can occur during or after catheter insertion and instillation, especially if the bladder lining is already inflamed or sensitive.

• Urinary Frequency/Urgency: There might be a temporary initial exacerbation of urinary frequency or urgency.

• Risk of Infection: As with any catheterization, there is a small risk of introducing infection, though sterile techniques are used to minimize this.

Each dose comes with the following:

• Prefilled syringe of 20 ml of Ozonated Glycerin (Glyzine)
• Catheter tip
• Clamshell packaging for protection during shipment and storage
• Sterile Gloves.