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Interstitial Cystitis

Painful bladder disorder

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Updated October 22, 2008

Cystoscopy

Cystoscopy is used to look at the inside of the bladder

Photo (c) A.D.A.M.
Interstitial cystitis (IC), also called "painful bladder syndrome" (PBS), is a disorder with symptoms of pain, pressure or discomfort related to the bladder and/or frequent or urgent need to urinate. It is not known what causes IC. It affects people of any age, ethnic background or gender, but most commonly occurs in women 80 to 90% of the time. It is not known exactly how many people around the world are affected by IC.

Symptoms

The symptoms of IC may include:
  • pain, pressure or discomfort that increases as the bladder fills with urine
  • pain in the lower abdomen or groin
  • pain in the urethra and rectum
  • pain in the vagina, for women
  • pain in the testes, scrotum or perineum, for men
  • painful sexual intercourse; for men, they may have pain with ejaculation
  • a frequent need to urinate, even at night
  • feeling the need to urinate right away
These symptoms may begin for no apparent reason. In some women, symptoms begin after surgery for hysterectomy, after childbirth or after a severe bacterial infection of the bladder. The symptoms may come on slowly and build up over time or they may begin suddenly and severely. Many people with IC experience “attacks” or flare-ups of their symptoms from time to time. Women may have a history of diagnoses such as endometriosis, dysmenorrhea, fibromyalgia, or vulvodynia.

Diagnosis

The diagnosis of IC can be complicated. The first step is to take a urine sample to check for bacterial infection of the urinary tract. Tests may be done to see if the symptoms are being caused by another disorder, such as bladder cancer, vaginal infections in women, inflammation of the prostate gland (prostatitis) in men, sexually transmitted infections or kidney problems. Age-appropriate screening for cancers such as cervical, prostate, or colon cancer will be performed.

If no infection or other disorder is present, a doctor who is a urinary tract specialist (urologist) may look at the inside of the bladder using a cystoscopy and may take a sample of the bladder tissue (biopsy) to examine under a microscope. Finding pinpoint hemorrhages (glomerulations) or small patches (called "Hunner’s lesions") in the bladder tissue would support the diagnosis of IC.

Treatment

At present, there is no cure for IC, nor is there one standard of treatment that is effective for everyone. Some medications that may relieve the symptoms of IC are Elmiron (pentosan), tricyclic antidepressants such as Elavil (amitriptyline) and antispasmodic drugs, such as Ditropan (oxybutynin).

Some medications may be put directly inside the bladder by way of a tube (catheter) that is inserted through the urethra in to the bladder. DMSO (dimethyl sulfoxide) is commonly given this way to treat IC. A catheter may also be used to fill the bladder with water and stretch it beyond its capacity (called "hydrodistention"). This type of treatment is done under anesthesia.

Some people with IC find that certain foods and beverages make their symptoms worse. Caffeine, citrus fruits and juices, tomatoes and tomato products, spicy foods, coffee, tea and alcoholic beverages have been identified by people with IC as causing problems for them. Self-help techniques, such as stress avoidance and relaxation therapy, may also help reduce symptoms.

NIDDK Research Network for IC/PBS

In 2008, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the U.S. National Institutes of Health (NIH), launched the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. This network will include six Discovery Sites that will conduct research studies and two Core Sites that will coordinate data collection, analyze tissue samples and provide technical support. The research will focus on two chronic pelvic pain disorders, IC/painful bladder syndrome (PBS) and chronic prostatitis (CP)/chronic pelvic pain syndrome (CPPS). The total research investment for this five-year project is estimated to be up to $37.5 million.

Sources:

Meijlink, Jane. "Interstitial Cystitis (IC)." Painful Bladder Syndrome Foundation. 2008. 07 Oct 2008

"What Is IC?" Interstitial Cystitis Association. 07 Oct 2008

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