Interstitial Cystitis Diagnosis and Treatment

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WHAT IS INTERSTITIAL CYSTITIS?


Interstitial cystitis — also called painful bladder syndrome — is a chronic condition defined by bladder pressure, bladder pain and sometimes pelvic pain, ranging from mild discomfort to severe pain. The bladder expands until it’s full and then signals the brain that it’s time to urinate, communicating through the pelvic nerves. This creates the urge to urinate for most people. With interstitial cystitis, these signals get mixed up — the need to urinate is felt more often and with smaller volumes of urine than typical.

DIAGNOSIS


  • Pelvic exam. — During a pelvic exam, our doctors examine the external genitals, vagina and cervix and feels the abdomen to assess internal pelvic organs.
  • Urine test — A sample of urine will be analyzed for evidence of a urinary tract infection.
  • Potassium sensitivity test — In this test, our doctors place two solutions — water and potassium chloride — into the bladder, one at a time. The doctor then asks the woman to rate on a scale of 0 to 5 the pain and urgency that is felt after each solution is instilled. If more pain or urgency is noticeably felt with the potassium solution than with the water, our doctors may diagnose interstitial cystitis. People with normal bladders can’t tell the difference between the two solutions.
  • Cystoscopy — With cystoscopy, our doctors insert a thin tube with a tiny camera (cystoscope) through the urethra, which allows our doctors to see the lining of the bladder. Along with cystoscopy, our doctors may inject liquid into the bladder to measure bladder capacity. Our doctors may perform this procedure, known as hydrodistention, after applying a local, regional, or general anesthetic to ensure comfort.
  • Biopsy — During cystoscopy under anesthesia, our doctors may remove a sample of tissue (biopsy) from the bladder and the urethra for examination under a microscope. This is to check for bladder cancer and other rare causes of bladder pain.

SURGICAL PROCEDURES FOR THE TREATMENT OF INTERSTITIAL CYSTITIS INCLUDE:


  • Fulguration — This minimally invasive method involves insertion of instruments through the urethra to burn off ulcers that may be present with interstitial cystitis.
  • Resection — This is another minimally invasive method that involves insertion of instruments through the urethra to cut around any ulcers.
  • Bladder augmentation — In this procedure, surgeons remove the damaged portion of the bladder and replace it with a piece of the colon, but the pain still remains and some people need to empty their bladders with a catheter many times a day.

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