Interstitial Cystitis

What Is It?

Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a chronic bladder health issue. It is a feeling of pain and pressure in the bladder area. Along with this pain are lower urinary tract symptoms which have lasted for more than 6 weeks, without having an infection or other clear causes.
Symptoms range from mild to severe. For some patients the symptoms may come and go, and for others they don’t go away. IC/BPS is not an infection, but it may feel like a bladder infection. Women with IC/BPS may feel pain when having sex. The more severe cases of IC/BPS can affect your life and your loved ones. Some people with IC/BPS have other health issues such as irritable bowel syndrome, fibromyalgia, and other pain syndromes.

Symptoms

Pain
The symptoms of IC/BPS vary for each patient, but the most common sign is pain (often with pressure). Patients with IC/BPS may have bladder pain that gets worse as the bladder fills. Some patients feel pain in other areas in addition to the bladder, such as the urethra, lower abdomen, lower back, or the pelvic or perineal area (in women, behind the vagina and in men, behind the scrotum). Women may feel pain in the vulva or the vagina, and men may feel the pain in the scrotum, testicle, or penis. The pain may be constant or may come and go.

Frequency
IC/BPS sometimes starts with urinary frequency. Frequency is the need to pass urine more often than normal. The average person urinates no more than 7 times a day. He or she does not have to get up at night more than once to use the bathroom. A patient with IC/BPS often has to urinate frequently both day and night. As frequency becomes more severe, it leads to urgency.

Urgency
Urgency to urinate is a common IC/BPS symptom. Some patients feel an urge that never goes away, even right after voiding. A patient may not notice or see this as a problem. In other cases, the onset is much more dramatic, with severe symptoms occurring within days, weeks or months.

Many patients with IC/BPS can point to certain things that make their symptoms worse. For some, their symptoms are made worse by certain foods or drinks. Many patients find that symptoms are worse if they are under stress (either physical or mental). For women, the symptoms may vary with their period. Both men and women with IC/BPS can have sexual problems due to this health issue. Women may have pain during sex because the bladder is right in front of the vagina. Men may have painful orgasm or pain the next day. It is unusual to experience leaking of urine with this disorder, and urinary leaking might be a sign of another problem.

 

Diagnosis

At this time, there is no medical test that can say a person has IC/BPS. Also, there is no test to say a person does not have IC/BPS. To make a diagnosis, your health care provider will first decide whether the symptoms are typical of IC/BPS. Next, they need to rule out other health issues that might be causing the symptoms. Some believe that IC/BPS is present if a patient has symptoms and no other cause for those symptoms is found. Others believe that more tests are needed to find out whether the patient has IC/BPS.

Below are some ways your health care provider may find out if you have IC/BPS:

Medical History
Your health care provider will ask you a number of questions about:

symptoms you are having

how long you have had the symptoms

how symptoms are changing your life

past health problems

current health problems

over-the-counter and prescription drugs you are taking

your diet, and about how much and what kinds of liquids you drink during the day

Physical and Neurological Exam
Your health care provider will examine you to look for the cause of your symptoms. In women, the physical exam will likely include your abdomen, the organs in your pelvis, and your rectum. In men, a physical exam will include your abdomen, prostate, and rectum. Your health care provider may also do a neurological exam to rule out any other problems. Patients with IC/BPS may have other mental health and/or anxiety disorders which may be linked to their condition.

Baseline Pain and Voiding Tests
Since the hallmark sign of IC/BPS is pain, your health care provider will conduct tests and ask you to fill out a series of questionnaires to find out your baseline pain value. The goal of the evaluation is to find pain location(s), intensity, and characteristics, and to identify factors that make pain or discomfort better or worse. Your health care provider will also ask how often you void. A very low voiding frequency or high voided volume should prompt your health care provider to look for some other urological condition beside IC/BPS.

Treatment

No single treatment works for all people with IC/BPS. Treatment must be chosen for each patient based on symptoms. Patients usually try different treatments (or combinations of treatments) until good symptom relief occurs. It is important to know that none of these IC/BPS treatments works right away. It usually takes weeks to months before symptoms improve. Even with successful treatment, the condition may not be cured. It is simply in remission. But, most patients can get significant relief of their symptoms and lead a normal life with treatment.

Most treatments are aimed at symptom control. IC/BPS treatment is often done in phases with constant monitoring of your pain and quality of life. It is important to talk to your health care provider about how your treatments are working so that together you can find the best treatment option for you.

Dr. Lawrence Newman, a leading urologist in Las Vegas, specializes in treating Interstitial Cystitis. Contact his office today for an appointment.