Interstitial cystitis (IC), also known as painful bladder syndrome (PBS) is a chronic condition where the patient experiences pressure and pain on the bladder and pelvic areas, ranging from mild discomfort to severe pain. IC/PBS usually occurs with not only pain, but significant urgency to urinate with many patients having frequency to void over 20 times per day, although little urine will be released. There is no known cause of IC/PBS but it does tend to occur more often in women with auto-immune disorders such as fibromyalgia and rheumatoid arthritis, and this condition affects women significantly more often than men.
The symptoms associated with interstitial cystitis include:
While these symptoms are similar to a urinary tract infection, this condition is not caused by a bacterial infection so it is not treatable with antibiotics. Think of IC/PBS as inflammation of the bladder so the symptom overlap with a UTI should make sense. Ask for a consultation with a specialist if you have been treated more than twice over a 6 month period, before the symptoms become more chronic and disrupting of your life. The classic patient comes to see us after being treated over and over for presumed UTIs and many times has seen multiple doctors before the correct diagnosis is made.
Unfortunately, there is no simple treatment for interstitial cystitis and a number of approaches may be necessary. Some patients benefit from physical therapy others may find relief with medications. A variety of medications ranging from NSAIDs and antihistamines to tricyclic antidepressants may be helpful. The FDA has approved a drug called Pentosan (Elmiron) specifically for IC/PBS, but it could take 2-6 months to be fully effective. The providers at East Valley Urology Center may suggest bladder instillations of soothing medications on a routine basis for a while to decrease the inflammation in your bladder wall. If not improved enough, Botox® injected into the bladder wall or nerve stimulation (Interstim®) can be used in order to relieve symptoms. Bladder distention may be performed with a cystoscope and this aids in diagnosis and can be helpful for symptoms in some patients as well (see attached photos). In most women, a combination of therapies are used and these are tailored to your specific symptoms.
You should write down a list of your symptoms and questions that you have about your condition. Make a list of any medications, vitamins, and supplements you are taking. Be prepared to talk to the doctor in detail about your urination habits and bring any records you may have from prior treatments. It might seem embarrassing, but the doctor will need as much information from you as possible to correctly diagnose and treat your condition.