Interstitial Cystitis (IC), also known as painful bladder syndrome, is a condition that results in recurring discomfort or pain in the bladder and the surrounding pelvic region. The symptoms vary from case to case and even in the same individual. People may experience mild discomfort, pressure, tenderness, or intense pain in the bladder and pelvic area. Symptoms may include an urgent need to urinate (urgency), a frequent need to urinate (frequency), or a combination of these symptoms. Pain may change in intensity as the bladder fills with urine or as it empties. Women’s symptoms often get worse during menstruation. They may sometimes experience pain with vaginal intercourse.
Because IC varies so much in symptoms and severity, most researchers believe that it is not one, but several diseases. In recent years, scientists have started to use the term painful bladder syndrome (PBS) to describe cases with painful urinary symptoms that may not meet the strictest definition of IC.
IC can affect people of any age, race or sex. It is, however, most commonly found in women.
Interstitial Cystitis Symptoms
Some or all of the following symptoms may be present with IC:
- Frequency: Day and/or night frequency of urination (up to 60 times a day in severe cases). In early or very mild cases, frequency is sometimes the only symptom.
- Urgency: The sensation of having to urinate immediately, which may also be accompanied by pain, pressure or spasms.
- Pain: Can be in the lower abdominal, urethral or vaginal area. Pain is also frequently associated with sexual intercourse. Men with IC may experience testicular, scrotal and/or perineal pain, and painful ejaculation.
- Other disorders: Some patients also report muscle and joint pain, migraines, allergic reactions and gastrointestinal problems. It appears that IC has an as yet unexplained association with certain other chronic diseases and pain syndromes such as vulvar vestibulitis, fibromyalgia, and irritable bowel syndrome. Many IC patients, however, have only bladder symptoms..
How is interstitial Cystitis Diagnosed?
Most IC patients have difficulty obtaining a diagnosis. To make a proper diagnosis of interstitial cystitis, a doctor must follow these steps:
- Take urine cultures to determine if there is a bacterial infection present.
- Rule out other diseases and/or conditions that have symptoms resembling IC. These diseases may include bladder cancer, kidney problems, tuberculosis, vaginal infections, sexually transmitted diseases, endometriosis, radiation cystitis and neurological disorders.
- Perform a cystoscopy with hydrodistention under general anesthesia if no infection is present and no other disorder is discovered. If distention under anesthesia is not performed, the diagnosis of IC may be missed. Cystoscopy during a routine office visit may not reveal the characteristic abnormalities of IC and can be painful for those who have IC. It is necessary to distend the bladder under general or regional anesthesia in order to see the pinpoint hemorrhages on the bladder wall that are the hallmark of this disease. A biopsy of the bladder wall may be necessary at this time to rule out other diseases such as bladder cancer and to assist in the diagnosis of IC. Interstitial cystitis is not associated with bladder cancer..
Interstitial Cystitis Treatment
At this time there is no cure for interstitial cystitis, nor is there an effective treatment that works for everyone. However, a vast majority of IC patients are helped by one or more of the following treatments:
- Oral Medications: There are several drugs used to treat the causes and symptoms of IC.
- Bladder Instillation: During a bladder instillation, also called a bladder wash or bath, the bladder is filled with a solution that is held for varying periods of time, averaging 10 to 15 minutes, before being emptied.
- Bladder Distention: During this procedure, the bladder is distended or stretched by filling it with liquid. This not only helps diagnose IC but also, for reasons that aren’t completely clear, brings relief to a significant number of patients.
- Other Treatments: These include changes in diet, stress reduction, visualization, bio-feedback, bladder retraining, and exercise. Additionally, surgery or electronic nerve stimulation might be required to treat IC..
For more information or to schedule an appointment, please contact the Center for Women’s Health at 913-491-6878.