LAUSR

order not to waste this volume, 15 mL air is pumped with the syringe into the urethra which pushes the residual solution into the bladder, and just a thin film of the drug remains attached to the surface of the urethra. There are just a few contraindications for catheter-free instillation using the syringe adapter. All circumstances which make urethral orifice invisible can inhibit drop-free instillation. In female patients: a deep orifice, opening on the vaginal wall and/or very narrow vaginal introitus mostly in sexually inactive, elderly patients. In males: most cases of hypoand epispadias, expressed stricture of the meatus or pinpoint phimosis. Like all instrumental or surgical interventions, catheter-free instillation naturally also needs some skill. But the learning curve of the therapists is quite short; in male patients 3–6 instillations, whereas in female patients 15–20 instillations can be necessary to reach the appropriate level. The vast majority of our cases were IC/BPS patients, but there are other indications too where catheter-free instillation proves to have advantages. These include the rapidly growing number of patients with radiotherapy-induced cystitis and the cytostatic drugsand BCG-induced cases of chemo-cystitis, chronic or frequently recurring bacterial cystitis, therapyresistant overactive bladder, all for therapeutic purposes. In the field of diagnostics, the syringe adapter can be used to perform retrograde urethrography or fistulographies.