interstitial Cystitis

Interstitial cystitis or painful bladder syndrome is a chronic inflammatory condition of the submucosal and muscular layers of the bladder. The disease is associated with urging, frequent urination, awakening at night to urinate (nocturia).

Patients with interstitial cystitis may also have such disorders of the bladder as urinary tract infection (UTI), overactive bladder, urethritis, urethral syndrome and prostatitis.

Signs and symptoms

Symptoms are often misdiagnosed as common bladder infection (cystitis) or UTI. However, interstitial cystitis is not caused by bacterial infection and antibiotics are ineffective. Symptoms of interstitial cystitis may also initially be associated with prostatitis and epididymitis, endometriosis and uterine fibroid (myoma).

Common symptoms: painful urination (pain that is aggravated by the filling of the bladder and/or relief comes when urinating), pain that worsens with taking a particular food or drink, dysuria (burning in the urethra during urination), and urinating every 10 minutes, a sense of urgency urination and pressure in the bladder and/or pelvis, urinary retention, pain during intercourse and discomfort.

All this leads to difficulties in normal life – driving, travel or work. During cystoscopy in 5-10% of patients with IC detected Hanner ulcers.

Causes of interstitial cystitis not conclusively established. Assumptions among experts: autoimmune (bladder attack by the immune system), neurological disorders, the theory of mast cells, infection and toxin production in the urine. Other reactions of the alleged – allergic, genetic and stress-psychological. In addition, recent studies indicate that patients may have a substance in the urine, which inhibits the growth of epithelial cells of the bladder. The reasons could also be drinking coffee or carbonated beverages, traumatic injury, urinary chemicals can “leak” into surrounding tissues, causing pain, inflammation and urinary symptoms.

Some patients have genetic background associated with this disease. Interstitial cystitis patients may suffer from multiple disorders (pleiotropic syndrome), such as disorders of the bladder and kidney, thyroid disease, severe headaches/migraines, panic disorder and mitral valve prolapse.

Diagnostics

• Review of clinical symptoms and laboratory tests (including the urinary marker phenylacetylglutamine)
• KCL test, also known as potassium sensitivity test
• In complex cases may use cystoscopy, hydrodistention and biopsy

Treatment of interstitial cystitis

Treatments may be as follows:

• Diet correction and stress management
• Physiotherapy, oral drugs
• Hanner ulcer treatment ( laser treatments, injections or fulguration) hydrodistention
• Neuromodulation  (effect on sacral nerve or other nerves)
• In more complex cases, surgery may be recommended for the purpose of diversion, bladder augmentation or cystectomy (removal of the bladder)

Treatment shall be prescribed by an experienced specialist on basis of diagnostic results only after doctor second opinion, because such diseases as interstitial cystitis treatable only with correct diagnosis and individual approach of experienced professionals.

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