Painful Bladder Syndrome: Understanding and Managing Interstitial Cystitis

Interstitial cystitis, also known as painful bladder syndrome, is a chronic urological ailment characterized by discomfort and pressure in the bladder. In certain instances, it can even lead to intense pelvic pain.

Managing IC can be challenging since it is a long-lasting condition with an unknown cause, and its diagnosis can be complicated due to its resemblance to other bladder disorders. Moreover, IC is more prevalent among women, with a ratio of approximately 1:10. Given its severity in certain cases, IC can significantly affect one’s quality of life. Nevertheless, there are various treatments and medications available that can provide relief.

What Is The Bladder?

The bladder is a muscular sac located in the pelvis, roughly the size of a pear when empty with a capacity somewhere between 400 and 600ml when full. It receives urine from the kidneys and stores it for excretion via the urethra.

It is a vital organ for keeping waste from building up within your body, and any disruption to this process due to poor bladder health can cause inflammation, bladder stones, infections, cancer, or incontinence, all of which can impact on your overall wellbeing.

Symptoms of Interstitial Cystitis

The symptoms of interstitial cystitis vary from case to case. For specific incidences, symptoms can range in severity and over time, hence why it can be difficult to diagnose. Symptoms can come on gradually, or abruptly for no apparent reason.

In mild cases, symptoms of IC can occur in “flares” in response to certain triggers. Because of this, it is often mistakenly self-diagnosed as a UTI. If you present any of the following symptoms, be sure to have a urine culture test.

• Pain or pressure when the bladder fills and relief when it is voided

• Urgent need to urinate

• Very frequent urge to urinate

• Only being able to expel a small amount of urine

• Pain in the pelvis or between the vagina and anus in women, and between the scrotum and anus in men; or chronic pelvic pain

• Pain during intercourse

How Is Interstitial Cystitis Diagnosed?

There is no single test that diagnoses IC, rather it is often a process of ruling other conditions or infections, such as urinary tract infections, an overactive bladder, bladder stones, bladder cancer, a sexually transmitted infection, endometriosis (in women), and BPH (in men).

The tests or procedures that may be performed to diagnose IC (i.e. rule out the above) include:

• Urinary culture samples to test for infection in the urine

• Cystoscopy – a procedure where a thin tube with a camera is inserted into the urethra to view the bladder

• Bladder hydrodistension – where the bladder is stretched with a sterile fluid using a cystoscope

• Biopsy – where a small piece of the bladder is cut out using a cystoscope for further analysis.

Treatment of IC

Depending on the symptoms, there is a range of treatment options available for interstitial cystitis. Generally these are implemented to help manage symptoms and return quality of life. Lifestyle factors and personal preferences will often influence what treatments are most suitable. These include:

• Dietary changes

• Quitting smoking

• Fluid intake management

• Physical therapies

• Surgery, such as a cystoscopy and hydrodistension

• Bladder training

• Medication

• Exercise

• Bladder instillations

• Nerve stimulation