Interstitial Cystitis

Interstitial cystitis (IC) is a condition that results in discomfort or pain in the bladder and the surrounding pelvic region. The symptoms can be different from case to case and even in the same individual. People may experience:

  • Mild discomfort.

  • Pressure.

  • Tenderness.

  • Intense pain in the bladder and pelvic area.

CAUSES

Because IC varies so much in symptoms and severity, people studying this disease believe it is not one but several diseases. Some caregivers use the term painful bladder syndrome (PBS) to describe cases with painful urinary symptoms. This may not meet the strictest definition of IC. The term IC / PBS includes all cases of urinary pain that cannot be connected to other causes, such as infection or urinary stones.

SYMPTOMS

Symptoms may include:

  • An urgent need to urinate.

  • A frequent need to urinate.

  • 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. Some of the symptoms of IC / PBS seem like those of bacterial infection. Tests do not show infection. IC / PBS is far more common in women than in men.

DIAGNOSIS

The diagnosis of IC / PBS is based on:

  • Presence of pain related to the bladder, usually along with problems of frequency and urgency.

  • Not finding other diseases that could cause the symptoms.

  • Diagnostic tests that help rule out other diseases include:

  • Urinalysis.

  • Urine culture.

  • Cystoscopy.

  • Biopsy of the bladder wall.

  • Distension of the bladder under anesthesia.

  • Urine cytology.

  • Laboratory examination of prostate secretions.

A biopsy is a tissue sample that can be looked at under a microscope. Samples of the bladder and urethra may be removed during a cystoscopy. A biopsy helps rule out bladder cancer.

TREATMENT

Scientists have not yet found a cure for IC / PBS. Patients with IC / PBS do not get better with antibiotic therapy. Caregivers cannot predict who will respond best to which treatment. Symptoms may disappear without explanation. Disappearing symptoms may coincide with an event such as a change in diet or treatment. Even when symptoms disappear, they may return after days, weeks, months, or years.

Because the causes of IC / PBS are unknown, current treatments are aimed at relieving symptoms. Many people are helped by one or a combination of the treatments. As researchers learn more about IC / PBS, the list of potential treatments will change. Patients should discuss their options with a caregiver.

SURGERY

  • Surgery should be considered only if all available treatments have failed and the pain is disabling. Many approaches and techniques are used. Each approach has its own advantages and complications. Advantages and complications should be discussed with a urologist. Your caregiver may recommend consulting another urologist for a second opinion. Most caregivers are reluctant to operate because the outcome is unpredictable. Some people still have symptoms after surgery.

  • People considering surgery should discuss the potential risks and benefits, side effects, and long- and short-term complications with their family, as well as with people who have already had the procedure. Surgery requires anesthesia, hospitalization, and in some cases weeks or months of recovery. As the complexity of the procedure increases, so do the chances for complications and for failure.

HOME CARE INSTRUCTIONS

  • All drugs, even those sold over the counter, have side effects. Patients should always consult a caregiver before using any drug for an extended amount of time. Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • Many patients feel that smoking makes their symptoms worse. How the by-products of tobacco that are excreted in the urine affect IC / PBS is unknown. Smoking is the major known cause of bladder cancer. One of the best things smokers can do for their bladder and their overall health is to quit.

  • Many patients feel that gentle stretching exercises help relieve IC / PBS symptoms.

  • Methods vary, but basically patients decide to empty their bladder at designated times and use relaxation techniques and distractions to keep to the schedule. Gradually, patients try to lengthen the time between scheduled voids. A diary in which to record voiding times is usually helpful in keeping track of progress.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.