Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a debilitating chronic condition affecting millions worldwide. One of the most effective treatments for IC/BPS is intravesical instillation therapy, which involves the direct instillation of medications into the bladder through a catheter. Self-administration of intravesical treatments has become increasingly common, enabling patients to avoid the time and expense of in-office care. Despite the potential benefits of self-instillation, there is limited understanding of why some patients choose to perform self-instillation while others opt for in-office treatment with a medical professional. This study aims to explore IC/BPS patients' attitudes and motivations toward self-instillation and identify barriers to its adoption.

IC/BPS patients who received bladder instillations between January 1st 2018 and April 1st 2022 were recruited and enrolled in 2 study groups: self-instillation performers and office-instillation receivers. Patients with prior self-instillation experience in non-treatment settings were included in the self-instillation group. Separate questionnaires for each group were created to assess attitudes toward intravesical therapy, with responses graded on a 5-point Likert Scale. Demographics were obtained through chart review, and group differences were assessed using the Mann-Whitney U test.

56 eligible patients were identified, of which 28 were reached via telephone. Ultimately, 22 patients completed study questionnaires and were enrolled, with 11 in each group. No significant differences in age, sex, ethnicity, insurance type, or presence of Hunner's lesions were found between groups (p > 0.05). Additionally, there were no differences in perceived ability to afford self-instillation or insurance coverage of materials (p > 0.05). The self-instillation group endorsed better control of painful flares (average score = 4.91, standard deviation = .30), saved time with fewer office visits (4.82, .41), more free time overall (4.82, .41), feeling more in control of their body (4.73, .47), having more self-autonomy (4.73, .47), and greater ability to work/perform daily activities (4.73, .47). Regarding self-instillation, the office-instillation group endorsed concern over the ability to administer therapy correctly (4.56, 1.21), having no one at home to help them (4.27, 1.01), self-instillation being too painful (4.18, 1.01), and inability to use a catheter correctly (4.09, 1.22).

Our study highlights that IC/BPS patients who perform self-instillation perceive several benefits to the therapy modality, including adequate control of painful flares, increased free time, and greater self-autonomy. These findings suggest an improved quality of life. The office-instillation group's concerns over self-administration abilities and catheter use indicate a need for better patient education and training.

This study provides insight into the attitudes of IC/BPS patients towards self-instillation of intravesical therapy. Though self-instillation may provide several benefits, concerns about patients' ability to perform the therapy correctly may hinder its adoption. Future studies should focus on developing educational materials and training programs to address these concerns and facilitate self-instillation uptake. Limitations of our study include small sample size and reliance on self-reported data.