Interstitial Cystitis
Interstitial cystitis (IC) is a painful bladder condition that often encompasses many of the symptoms associated with an actual urinary tract infection but in face of a negative urine culture.
Although majority of IC patients are women, some men do also suffer from this same condition as well.
Common complaints for Interstitial Cystitis are as follow:
- Suprapubic and/or perineal pain
- Urinary urgency and frequency
- Pain when the bladder fills up followed by relief when it empties
- Dyspareunia
The intensity of symptoms can very from very mild to flare-ups that can physically and emotionally impair an individual’s daily routine.
Although the actual cause of IC is unknown at this time, some research studies have suggested the absence or a very deficient mucosal lining within the bladder.
The workup for IC begins with a detailed history and physical examination. It is usually followed by a urinalysis as well as a urine culture. A functional voiding study such as a uroflow and postvoid residual study maybe indicated.
A potassium sensitivity test is one of the additional tests used to diagnose IC. It involves placement of a catheter and the instillation of water then followed separately with a potassium concentrated solution. If pain is elicited with the instillation of the later solution then it strongly suggest the presence of IC.
Cystoscopy with hydrodistention of the bladder is probably one of the most common workup for IC. During hydrodistention, the clinician is looking for signs of “glomerulization” or spotting (Hunner’s ulcers) to appear in the bladder mucosal lining. In addition, a biopsy maybe performed to evaluate for any signs of inflammation as well.
Interstitial Cystitis Treatment
Treatment for IC varies significantly. One of the most common approaches is to identify any environmental and dietary causes of IC.
Other therapies include:
- Nonsteroidal anti-inflammatry
- Tricyclic antidepressants
- Anti-histamines
- Pentosan (Elmiron) which is designed to enhance the lining of the bladder
- Anticholinergic medications
- Sacral nerve stimulation (Interstim)
Pain management often play a role as well as some patients will need to rely on narcotics to reduce their discomfort and/or have a transcutaneous electrical nerve stimulator (TENS) placed.
On occasion, patients may obtain relief by having medications directly instill into their bladder on a regular basis. The basic premise of most of these bladder instillation is to denude the defective bladder lining and encourage the regrowth of a more robust bladder mucosa.
In extremely rare cases, patients who are functionally crippled by the symptoms of IC may chose a drastic step to relieve their pain by either undergoing a complete removal of their bladder along with hysterectomy to remove the source of discomfort and / or undergo a procedure to increase their bladder via an augmentation.
Because IC is so prevalent, many patients also receive help by joining their local IC support group to speak to other members and get some tips on how to handle their IC symptoms.
