Interstitial Cystitis (IC) is a tricky condition. It’s long-term, the cause is unknown, and diagnosis can be difficult due to IC having similar symptoms to other bladder conditions. It is also far more common in women, with the ratio of incidence being roughly 1:10.
Due to the severity in some cases, IC can have a real impact on the quality of life. However, some treatments and medications can offer relief.
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. Any disruption to this process due to poor bladder health can cause inflammation, bladder stones, infections, cancer, or incontinence, all of which can impact your overall well-being.
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. In addition, 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
• Persistent 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
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.
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
• Bladder instillations
• Nerve stimulation
Dr Arianayagam is an experienced urologist and specialist urological surgeon based in Sydney. He works from his urology clinic in Bella Vista and at both public and private hospitals across Sydney and treats all kinds of general urological problems.
If you have any questions about Interstitial Cystitis or would like to book an appointment, please feel free to call. We will always provide our patients with compassionate care and advice.
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