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Interstitial Cystitis

Interstitial cystitis is a chronic inflammation of the bladder that results in pelvic pain, frequent urination and strong urges to urinate. This condition is complex and poorly understood. It is also often misdiagnosed.

Interstitial cystitis also is called painful bladder syndrome.

The Interstitial Cystitis Association estimates 3 million to 8 million women in the United States have the condition. But this number might underestimate the true prevalence of the condition because of misdiagnosis. Women are five times more likely to experience it than men. Women of all ages can get interstitial cystitis, but it is usually diagnosed when they are in their 20s and 30s.

What causes interstitial cystitis?

The cause is unknown.

What are the symptoms of interstitial cystitis?

Patients experience a variety of complaints. Some classic symptoms include:

  • An uncontrollabe urge to urinate.
  • An increase in the number of times you urinate.
  • A need to wake up more than once a night to urinate.
  • Pain that worsens when the bladder is full.

Other symptoms that are common but not experienced by everyone with interstitial cystitis include:

  • Lower back or abdominal pain.
  • Burning during urination.
  • Painful sexual intercourse.
  • Urinary incontinence.
  • Vaginal burning.
  • Symptoms of a recurrent bladder infection (burning during urination, frequent urination and strong urges to urinate), but a lab test of urine is negative for infection-causing bacteria.

Patients also may develop other pain conditions such as vulvodynia, vulvar vestibulitis, high-tone pelvic-floor muscle dysfunction, irritable bowel syndrome, endometriosis and fibromyalgia.

How is interstitial cystitis diagnosed?

Interstitial cystitis is mainly diagnosed with a review of your family medical history and a physical exam. After ruling out other bladder abnormalities, the doctor can diagnose interstitial cystitis if you are experiencing urinary urgency, urinary frequency, repeated night-time bathroom trips and pain.

The doctor also performs a thorough evaluation for related conditions. A cystoscopy is often necessary to rule out other conditions that might affect the bladder.

How is interstitial cystitis treated?

Because of the complexity of interstitial cystitis, the many patients in the United States must visit multiple doctors for treatment. This is typically not the case at the Center for Urogynecology and Pelvic Surgery, where our doctors have training to detect interstitial cystitis and offer a spectrum of treatment options. These include but are not limited to:

  • Taking medications. Many medications are used to treat interstitial cystitis. Often, more than one is necessary to treat different components of the condition.
  • Modifying your diet. Minimizing bladder irritants in your diet can improve symptoms. Common culprits include alcohol, caffeine and artificial sweeteners. Dietary changes can be tailored to your needs but are important in managing interstitial cystitis.
  • Strengthening the pelvic floor. Managing or treating pelvic floor muscles through training with a physical therapist is critical. The therapist can teach you to maintain a stable level of muscle contraction that helps to suppress strong urges to urinate.
  • Instilling medicine into the bladder. Chemicals that can help relieve some symptoms are delivered to the bladder through a catheter. Treatments are given once a week for seven weeks in the doctor’s office.
  • Stimulating the bladder and tibial nerves. This approach can help control urinary urgency and frequency. This is accomplished with the placement of an implant that is similar to a pacemaker. The procedure, called sacral neuromodulation, involves putting a generator in the buttocks and connecting it to a wire resting near the sacral nerve that comes from the bladder. The generator sends electrical impulses that slow down the signals causing frequent urination. This outpatient procedure is an appealing option for patients whose condition has not improved using conventional treatments.
  • Surgery. There are some surgical procedures available for this condition.

ChristianaCare Center for Urogynecology and Pelvic Surgery

Christiana Hospital
Medical Arts Pavilion 2
4735 Ogletown-Stanton Road, Suite 1208, Newark, DE 19713 directions
fax 302-623-4056

ChristianaCare Concord Health Center
161 Wilmington-West Chester Pike, Chadds Ford, PA 19317 directions
610-361-1030, option 9

Smyrna Health & Wellness Center
100 S. Main Street, Suite 215
Smyrna, DE 19977 directions

Wilmington Hospital
501 West 14th Street
Gateway Building, 2nd Floor
Wilmington, DE 19801