Interstitial Cystitis

Interstitial cystitis (IC), often called painful bladder syndrome, is a tricky condition. It’s tough to diagnose, and though treatments can make life with it better, there’s no cure.

Causes of Interstitial Cystitis #

It’s not clear why it happens, but there are several ideas:

• A problem with bladder tissue lets things in your pee irritate your bladder.

• Inflammation causes your body to release chemicals that cause symptoms.

• Something in your urine damages your bladder.

• A nerve problem makes your bladder feel pain from things that usually don’t hurt.

• Your immune system attacks the bladder.

• Another condition that causes inflammation is also targeting the bladder.

Symptoms of Interstitial Cystitis #

• Bladder pressure and pain that gets worse as your bladder fills up.

• Pain in your lower tummy, lower back, pelvis, or urethra (the tube that carries pee from your bladder out of your body)

• For women, pain in the vulva, vagina, or the area behind the vagina

• For men, pain in the scrotum, testicles, penis, or the area behind the scrotum

• The need to pee often (more than the normal 7-8 times daily)

• The feeling you need to pee right now, even right after you go

• For women, pain during sex

• For men, pain during orgasm or after sex

Diagnosis of Interstitial Cystitis #

Urinalysis and urine culture #

You’ll be asked to pee in a cup. It’ll be sent to a lab to check for infection.

Postvoid residual urine volume #

Using an ultrasound, this test measures the amount of pee that remains in your bladder after you go to the bathroom.

Cystoscopy #

A thin tube with a camera is used to see the inside of the bladder and urethra. This is usually done only if there is blood in your pee or if treatment doesn’t help.

Bladder and urethra biopsy #

A small piece of tissue is taken and tested. This is usually done during cystoscopy.

Bladder stretching #

Your bladder is filled with liquid or gas to stretch it out. You’ll be asleep under anesthesia. Sometimes this is also used as a treatment. This is done with a cystoscopy.

Prostate fluid culture (in men) #

Your doctor will need to press on your prostate and milk a sample to test. This is not commonly done.

Treatment of Interstitial Cystitis #

Physical therapy #

Different techniques are used to help relax your pelvic muscles.

Amitriptyline #

This drug controls bladder spasms. It’s the most widely used oral medication for IC.

Pentosan (Elmiron) #

It’s not clear how this drug works, but it might help rebuild the bladder tissue lining. It can take a few months to relieve symptoms.

Hydroxyzine #

This drug is an antihistamine and can be helpful if you have to pee a lot at night.

Dimethyl sulfoxide (DMSO) #

For people who haven’t found relief through other drugs, this drug is placed in the bladder with a catheter. It’s believed to work by fighting inflammation and blocking pain. Doctors don’t often recommend it because it may temporarily worsen symptoms and takes multiple doctor visits.

Bladder stretching #

Slowly stretching the bladder wall with fluid may help relieve symptoms. If it’s helpful, the effect usually lasts less than 6 months. Repeat treatment may help.

Steroids #

If you have ulcers called Hunner’s lesions on your bladder, a doctor may remove them, burn them, or inject them with steroids.

Neurostimulation #

The doctor implants a device that delivers small electrical shocks to your nerves to change how they work.

OnabotulinumtoxinA (Botox) injections #

This temporarily paralyzes the bladder muscle to help relieve some of the pain.