Interstitial Cystitis (IC)
What is Interstitial Cystitis?
Interstitial cystitis (IC) is a chronic inflammatory condition of the bladder. Its cause is unknown. "Common" cystitis, also known as a urinary tract infection or UTI, is caused by bacteria and is usually successfully treated with antibiotics. Unlike common cystitis, IC is believed not to be caused by bacteria and does not respond to conventional antibiotic therapy. It is important to note that IC is not a psychosomatic disorder nor is it caused by stress.
Symptoms
Some or all of these symptoms may be present:
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, as well as the more common symptoms of IC described above. 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.
Diagnosis
Most IC patients have difficulty obtaining a diagnosis. To make a proper diagnosis of IC, a Urologist 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. IC is not associated with bladder cancer.
Treatments
At this time there is no cure for IC, nor is there an effective treatment which works for everyone. However, a vast majority of IC patients are helped by one or more of the following treatments:
- Oral medication
- Bladder instillations
- Diet
- Physical Therapy
The goal of Physical Therapy for IC patients is to relax the pelvic floor muscles and avoid overly stressing them. Many people with IC have problems with this group of muscles and develop a condition called Pelvic Floor Dysfunction (PFD).
PFD is seen in about 70% of IC patients and can worsen symptoms.
Click here for more information on Pelvic Floor Dysfunction (PFD)