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Interstitial Cystitis

Far more common in women than men, interstitial cystitis causes bladder pressure, pain in the bladder and pelvic region, and sometimes pain with intercourse.

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.

What are the symptoms of Interstitial Cystitis?

If you have interstitial cystitis, your symptoms may vary over time, periodically flaring. Symptom severity is different for everyone, and some people may experience symptom-free periods.

These symptoms are most common:

  • Pain in the pelvis, vagina, or anus in women
  • Pain between the scrotum and anus (perineum) in men
  • Pelvic pain that won’t go away
  • An urgent need to urinate
  • Urinating often, in small amounts, throughout the day and night. In severe cases you may urinate up to 60 times a day.
  • Pain or discomfort while the bladder fills
  • Relief after you urinate
  • Blood in the urine
  • Pain during sexual intercourse or orgasm

What causes Interstitial Cystitis?

The exact cause of IC is unknown, but it’s likely that there are many contributing factors. You could have a defect in the protective lining (epithelium) of your bladder. Such a leak can allow toxic substances excreted from your urine to irritate your 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:

  • Females are 10 times more likely to be diagnosed with IC than males. Up to 12% of women are affected.
  • Most people with IC are diagnosed in their 30s or older.
  • IC may be associated with other chronic pain disorders, such as irritable bowel syndrome or fibromyalgia.

How is Interstitial Cystitis diagnosed?

Your doctor will look for a pattern of symptoms that are characteristic of IC, including urgency, frequency, and/or pelvic pain in any combination. It is often mistaken for 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 Michigan Institute of Urology in Southeast Michigan:

Your doctor will ask about your medical history and will perform an exam.

Other tests may include:

  • 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.

How is Interstitial Cystitis treated?

Treating IC involves multiple therapies to control your 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:

  • Physical therapy, biofeedback, and bladder re-training: The pelvic floor muscles may need strengthening or relaxation in some situations.
  • Medication: Antidepressants and antihistamines can 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.” Such medications include heparinoid compounds (heparin) and DMSO (dimethyl sulfoxide) which relieve pain and inflammation.
  • Cystoscopic evaluation: A scope evaluates the bladder to ensure there are no other causes for the symptoms. This also may find Hunner’s lesions, which can be destroyed to relieve symptoms.
  • Bladder hydrodistention: In this procedure the physician overfills the bladder while you’re under general anesthesia.

A healthy diet is important to avoid future episodes of interstitial cystitis.

The Michigan Institute of Urology is committed to advancement of the care of this condition and often has ongoing research trials in which you may qualify.

 

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