Interstitial Cystitis

What Is Interstitial Cystitis?

Interstitial cystitis (IC), also known as painful bladder syndrome (PBS), is a chronic condition where the patient experiences pressure and pain on the bladder and pelvic areas, ranging from mild discomfort to severe pain. IC/PBS usually occurs with not only pain, but significant urgency to urinate with many patients having frequency to void over 20 times per day, although little urine will be released. There is no known cause of IC/PBS, but it does tend to occur more often in women with autoimmune disorders, such as fibromyalgia and rheumatoid arthritis, and this condition affects women significantly more often than men.

When Should I See a Doctor for Painful Bladder?

The symptoms associated with interstitial cystitis include:

• Chronic pain in the pelvic area including the vagina, vulva, and anus
• Persistent urge to urinate
• Frequent urination that is bothersome and without passing much urine
• Pain when the bladder is full or during or after sexual intercourse

While these symptoms are similar to a urinary tract infection, this condition is not caused by a bacterial infection; therefore, it is not treatable with antibiotics. Think of IC/PBS as inflammation of the bladder, so the symptom overlap with a UTI should make sense.  Ask for a consultation with a specialist if you have been treated more than twice over a 6-month period, before the symptoms become more chronic and disrupting of your life. The classic patient comes to see us after being treated over and over for presumed UTIs and many times has seen multiple doctors before the correct diagnosis is made.

How Is Interstitial Cystitis Treated?

Unfortunately, there is no simple treatment for interstitial cystitis and a number of approaches may be necessary. Some patients benefit from physical therapy, while others may find relief with medications. A variety of medications ranging from NSAIDs and antihistamines to tricyclic antidepressants may be helpful. The FDA has approved a drug called Pentosan (Elmiron) specifically for IC/PBS, but it could take 2-6 months to be fully effective. The providers at Southeast Urogyn may suggest bladder instillations of soothing medications on a routine basis to decrease the inflammation in your bladder wall. If not improved enough, Botox® injected into the bladder wall or nerve stimulation (Axionics®) can be used in order to relieve symptoms. Bladder distention may be performed with a cystoscope and this aids in diagnosis and can be helpful for symptoms in some patients as well (see attached photos). In most women, a combination of therapies are used and these are tailored to your specific symptoms.

Do I Need to Prepare Anything Before Seeing a Doctor for Interstitial Cystitis?