Interstitial Cystitis/Painful Bladder Syndrome

Painful bladder syndrome is a chronic inflammation of the bladder wall. This condition is not related to any bacteria. It is tough to diagnose, no specific treatments work for everyone, and there is no cure for this condition. Interstitial cystitis can affect both men and women and is more common in women. This condition affects individuals in different ways.

Symptoms vary from person to person, and they could be mild to severe or constant. Symptoms are similar to a bladder infection. During menstrual periods these symptoms become worse. You may experience any or all of the symptoms like

• pelvic pain,
• discomfort when the bladder is filling,
• frequent urination,
• urinating small amounts,
• women experience pain in the vulva, vagina, or backside of the vagina,
• men experience pain in the scrotum, testicles, penis, or the area behind the scrotum.

Reasons for interstitial cystitis are not understood completely. It might have caused due to

• Autoimmune disease
• Allergies
• Defects in the lining of the bladder
• Vascular disease
• Mast cell abnormalities
• Abnormal substances present in the urine
• Unidentified infections
• Inflammation
• The immune system affects the bladder.

There is no specific test to determine interstitial cystitis. The doctor will first test to rule out other infections and conditions such as urinary tract infections, bladder cancer, sexually transmitted diseases, and kidney stones.

Different tests performed for every individual-

• Urinalysis and urine culture
• postvoid residual urine volume
• cystoscopy
• bladder and urethra biopsy
• bladder stretching
• prostate fluid culture for men

Interstitial cystitis cannot be cured but can be treated in many ways. There is no particular treatment for which an individual responds. Your doctor may try various options for you to find a treatment that suits you.

Lifestyle treatments – for many people, interstitial cystitis goes away by itself.

In the first stage, one has to identify what triggers them and try to change that.

Lifestyle changes such as - training the bladder to hold urine, stress control, wear loose cotton clothes, relaxing exercises, quit smoking, foods that could irritate your bladder- citrus fruits, tomatoes, chocolate, carbonated drinks, alcohol, etc.

If lifestyle changes are of no help, then treatments like physical therapy, amitriptyline, pentosan, hydroxyzine, dimethyl sulfoxide are in the second line.

If second-line treatments are not helpful, then the doctor may do a cystoscopy, bladder stretching, and steroids.

if the above medication and procedures are not helpful and this condition is severely affecting your day-to-day life, then the doctor may try treatments such as neurostimulation, Botox, cyclosporine, and surgery.

The symptoms of interstitial cystitis are similar to those of chronic urinary tract infection, but it is not related to bacteria. If the condition is left untreated, it can have a long-lasting impact on quality of life. Chronic pain and improper sleep with this condition can cause emotional stress and may also lead to depression.