Interstitial Cystitis

Interstitial cystitis (IC), also known as bladder pain syndrome, is a chronic condition characterized by recurring discomfort or pain in the bladder and pelvic region. The symptoms of IC can vary from person to person and may include:

• Pelvic pain or pressure
• Bladder pain or burning sensation
• Frequent or urgent need to urinate
• Painful urination
• Discomfort or pain in the urethra, vagina, or penis

The exact cause of IC is not well understood, but several factors are thought to contribute to its development, including:

• Bladder lining defects or leaks
• Immune system problems
• Nerve signal problems
• Hormonal changes
• Infections or inflammation

Diagnosis

Diagnosing IC can be challenging, as the symptoms are similar to those of other conditions, such as urinary tract infections (UTIs) or overactive bladder. A diagnosis of IC is typically made after:

• A thorough medical history and physical exam
• Urinalysis and urine culture to rule out UTIs
• Cystoscopy, a procedure that uses a flexible tube with a camera to visualize the inside of the bladder
• Hydrodistension, a procedure that involves filling the bladder with water to assess its capacity and look for signs of IC

Treatment

Treatment for IC typically involves a combination of lifestyle changes, medications, and other therapies. Lifestyle changes may include:

• Dietary modifications, such as avoiding trigger foods that can irritate the bladder
• Stress management techniques, such as meditation or yoga
• Bladder training to help manage symptoms

Medications may include:

• Pentosan polysulfate sodium (Elmiron), an oral medication that helps repair the bladder lining
• Amitriptyline, an antidepressant that can help relieve pain and reduce symptoms
• Antihistamines or anticholinergics to help manage symptoms such as frequency and urgency

Other therapies may include:

• Bladder instillations, where medications are inserted directly into the bladder through a catheter
• Physical therapy to help manage pelvic floor dysfunction
• Nerve stimulation techniques, such as transcutaneous electrical nerve stimulation (TENS)

Complications

If left untreated or undertreated, IC can lead to complications such as:

• Reduced bladder capacity
• Increased frequency and urgency of urination
• Pelvic floor dysfunction
• Depression and anxiety

Prognosis

The prognosis for IC varies depending on the severity of symptoms and the effectiveness of treatment. With proper management, many people with IC can experience significant improvement in their symptoms and quality of life.