Interstitial Cystitis – Painful Bladder Syndrome

Interstitial cystitis is diagnosed and treated by members of the Urology Division of Premier Medical Group. Interstitial cystitis (IC) is a chronic inflammatory condition of the bladder. The normal bladder has a natural lining of mucoid proteins, protecting it from the toxins in the urine. With IC, this protective layer is faulty. When this happens, the toxins in urine penetrate the bladder wall, causing pain when you urinate. IC does not respond to antibiotics because it is not a bacterial infection, such as a typical bladder infection. Some patients suffer from intense pain, while others only experience mild discomfort. IC is not curable, but most patients respond to treatment and lifestyle changes.

Until the mid-1980s, IC was not commonly recognized and often misdiagnosed as a urinary tract infection. Today, an estimated 500,000 people are diagnosed with IC, and about 90 percent of them are women. People of any age can be affected with IC, although it is rare in children. About two-thirds of patients are in their 20’s, 30’s, or 40’s.

PBS syndrome is seen in the Poughkeepsie, Fishkill, Kingston, Rhinebeck and Newburgh locations.

What causes interstitial cystitis?

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It’s not clear what the causes IC. Some theories are:

  • Frequent bladder infections
  • Allergies
  • Certain foods
  • Some evidence suggests that IC is caused by the body’s own natural defense system turning on itself
  • Women with IBS or fibromyalgia are more prone to IC
  • Inflammation from another part of the body
  • Yet undefined bacteria
  • Environment

What are the symptoms of interstitial cystitis?

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IC is frequently misdiagnosed as a urinary tract infection, the symptoms of which are similar. Symptoms can include:

  • Urgency to urinate
  • Painful sexual intercourse
  • With women, symptoms increase during menstrual cycle
  • Decreased bladder capacity
  • Pressure, pain and tenderness around the pelvic area and the perineum (area between the vagina or scrotum and the anus)
  • In men, discomfort in the penis and scrotum

How is interstitial cystitis diagnosed?

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There are two types of Interstitial Cystitis. Non-ulcerative is the most common and typically affects young to middle age women. Ulcerative IC is usually diagnosed in middle-aged to older women who have a lower bladder capacity. Because the symptoms of IC are similar to other disorders as well as common urinary tract infections, your doctor must first rule these out, a procedure that can take some time.

Medical tests may include:

  • A urinalysis and urine culture
  • Laboratory examination of prostate secretions
  • Cystoscopy to examine the inside of the bladder and urethra to detect inflammation
  • Biopsy of the bladder wall to rule out bladder cancer and confirm bladder wall inflammation

How is interstitial cystitis treated?

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There is no cure for IC, only treatment for the symptoms. These include:

  • Oral medication: Both prescription and over-the-counter
  • Bladder distention: A procedure done under anesthesia in which the bladder is stretched with water
  • Bladder instillation: This is also called a bladder wash. The bladder is filled with a special solution that is held for a short time.
  • Transcutaneous electrical nerve stimulation (TENS): A weekly procedure in which your doctor places small wires on your lower back or legs; mild electric pulses enter the body for several minutes.
  • Smoking Cessation: Avoid the major known cause of bladder cancer.
  • Exercise: Some patients have benefited from mild exercises.
  • Bladder training: A practice in which you void at scheduled times, using relaxation techniques and other distractions, until you can lengthen the time between urinations.

Surgical treatments include:

  • Implantation of an electrical nerve stimulator to relieve symptoms
  • Laser surgery (only used for the ulcerative form of IC)
  • Urinary diversion: The bladder is removed and your doctor creates a tube from a section of your bowel and places the ureters in this tube. This is then diverted into an opening in the abdomen called a “stoma”. The urine is collected in an external bag. Another option is to build an internal pouch from a section of bowel that the patient empties by self-catheterization.