Interstitial Cystitis

What Is It?

Interstitial cystitis is a puzzling bladder condition, in which the bladder wall becomes irritated or inflamed, causing pain and frequent or painful urination.

The symptoms of interstitial cystitis are often similar to the symptoms of a urinary-tract infection. However, in interstitial cystitis, there is no infection, and the symptoms do not respond to antibiotic treatment. The exact cause of interstitial cystitis remains a mystery, although researchers continue to investigate possible causes, such as unidentified bacteria, an allergic or immune-system reaction, a toxic substance in the urine, or a neurological problem in the bladder wall. There also is some evidence that interstitial cystitis may not be just one illness, but several illnesses that share similar symptoms.

It is estimated that more than 700,000 people in the United States have interstitial cystitis, usually between the ages of 20 to 50. Approximately 90 percent of people with interstitial cystitis are women. It is unknown why interstitial cystitis is more common in women. The disease is not known to be genetic (inherited) or caused by toxins in the environment.

Symptoms

Interstitial cystitis may cause:

• Frequent urination
• An intense urge to urinate
• Awakening from sleep to pass urine
• A burning sensation during urination
• Pain, pressure or tenderness in the area of the bladder — midline, below the navel or in some other portion of the pelvis
• Increasing discomfort as the bladder fills
• Pain during sexual intercourse
• In men, pain or discomfort in the penis and scrotum
• In women, worsening symptoms during menstrual periods

Diagnosis

Your doctor will ask you about your urine (urine color, odor, presence of blood), symptoms during urination, any pain you are having, and if you are having fever, nausea or vomiting. Your answers to these questions will provide clues about other possible causes of your symptoms, such as a urinary-tract or kidney infection.

Next, your doctor will examine you and will collect urine from you for laboratory tests that check for signs of infection and infection-causing bacteria. Women usually will need a pelvic exam and men will need a digital rectal exam to check the prostate gland.

There is no one sign or test that can tell you immediately if you have interstitial cystitis. Usually, doctors diagnose the condition after a person has had persistent symptoms without any other cause being found.

Your doctor probably will refer you to a urologist to help make the diagnosis. He or she will do a test called cystoscopy to look for indications that you have interstitial cystitis and make sure there are no other causes of your symptoms. During cystoscopy, the urologist uses a small tubelike instrument to look inside your bladder and examine its inner lining. In a test called a biopsy, a small sample of tissue may be taken from your bladder wall to be examined in a laboratory to look for signs of inflammation and to check for other illnesses, including cancer. During the cystoscopy, your urologist may test your bladder's maximum capacity by filling it with sterile water. This is to determine whether interstitial cystitis has reduced your bladder's ability to hold urine.