Interstitial Cystitis
Pressure or Pain in Your Bladder or Pelvis?
Far more common in women than men, interstitial cystitis causes bladder pressure, pain in the bladder and pelvic region, and sometimes pain with intercourse.
Overview
What is Interstitial Cystitis?
Interstitial cystitis (IC) is a chronic condition causing bladder pressure, bladder pain, pelvic pain and sometimes pain with intercourse. The pain ranges from mild discomfort to severe pain. The condition is a part of a spectrum of diseases known as painful bladder syndrome. If you have urinary pain that lasts for more than six weeks and is not caused by other conditions like infection or kidney stones, you may have IC.
Symptoms
What are the symptoms of Interstitial Cystitis?
The signs and symptoms of interstitial cystitis vary. If you have interstitial cystitis, your symptoms may also vary over time, periodically flaring. Symptom severity is different for everyone, and some people may experience symptom-free periods.
You may experience the following common symptoms:
- Pain in the pelvis, vagina or anus in women
- Pain between the scrotum and anus in men (perineum)
- Chronic pelvic pain
- A persistent, urgent need to urinate
- Frequent urination, often of small amounts, throughout the day and night. In severe cases patients can urinate up to 60 times a day.
- Pain or discomfort while the bladder fills and relief after urinating
- Blood in the urine
- Pain during sexual intercourse or orgasm
Cause
What causes Interstitial Cystitis?
The exact cause of interstitial cystitis isn’t known, but it’s likely that there are many contributing factors. People with interstitial cystitis may have a defect in the protective lining (epithelium) of the bladder. A leak in the epithelium may allow toxic substances in urine to irritate the bladder wall.
Other possible, but unproven, contributing factors are an autoimmune reaction, heredity, infection or allergy.
Factors associated with a higher risk of interstitial cystitis are:
- Biological Sex: Women are 10 times more likely to be diagnosed with interstitial cystitis than men. Up to 12% of women are affected.
- Age: Most people with interstitial cystitis are diagnosed during their 30s or older
- Having a chronic pain disorder: Interstitial cystitis may be associated with other chronic pain disorders, such as irritable bowel syndrome or fibromyalgia.
Diagnosis
How is Interstitial Cystitis diagnosed?
The diagnosis of IC is based on the presence of the characteristic pattern of symptoms of urgency, frequency and/or pelvic pain in any combination and is frequently misdiagnosed as a urinary tract infection. For this reason, there is, on average, a four-year delay between the time the first symptoms occur, and the diagnosis is made. The diagnosis is made by ruling out other causes.
What to know before your visit to MidLantic Urology in Philadelphia and surrounding counties:
- During your visit, your doctor will ask you questions regarding your medical history and will perform an exam.
Other tests that may be performed during or after your visit are:
- A urine test: A sample of your urine can be analyzed for signs of a urinary tract infection
- Urodynamics: A technique that measures pressure in the bladder and urine flow.
- Cystoscopy : Your doctor inserts a thin tube with a tiny camera (cystoscope) through the urethra, showing the lining of your bladder.
- Urine cytology: Your doctor collects a urine sample and examines the cells to help rule out cancer.
Treatment
How is Interstitial Cystitis treated?
The key principle in treating IC is to use multiple therapies to control whatever is causing the symptoms. Patients with mild IC may not need much therapy and sometimes diet modification or stress reduction can help. Those with a severe condition may require more therapies, including:
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- Physical therapy, biofeedback and bladder re-training: The pelvic floor muscles may need strengthening or relaxation in some situations.
- Medication: Multimodal pain management strategies, tricyclic antidepressants and antihistamines to reduce pain and urination frequency. The oral medication pentosan polysulfate is believed to provide a protective coating to the bladder, allowing it to heal. Some medications can be instilled in the bladder by a catheter to help provide more immediate relief. These are often referred to as “bladder cocktails.” Medicines that are given this way include heparinoid compounds (heparin) and DMSO (dimethyl sulfoxide), which relieves pain and inflammation.
- Cystoscopic evaluation: A scope is done to evaluate the bladder and ensure there are no causes, other than IC, for the symptoms. This also may find Hunner’s lesions which can be fulgurated or burned to relieve symptoms.
- Bladder hydrodistention: In this procedure the physician overfills the bladder while the patient is under general anesthesia.
Following a healthy diet is important to avoiding future episodes of interstitial cystitis.
Dr. Cara O'Brien discusses solutions for interstitial cystitis.
Schedule an appointment with a MidLantic Urology Physician near you today!
