Interstitial Cystitis & Painful Bladder Syndrome

Definition

Interstitial Cystitis, also known as Bladder Pain Syndrome, or Painful Bladder Syndrome, is a non-microbial chronic inflammatory disease of the bladder characterized by pain in the bladder and pelvic area, constant urgency, and frequent urination. 90% of the patients are female, the age of onset of symptoms is often between the ages of 30-50.

Symptoms

Typical symptoms are bladder pain, frequent urination and a constant urge to urinate. The sensation of pain usually becomes more intensified as the bladder fills and decreases when urinating. The exacerbation and well-being seen in the complaints are typical for this disease. Sexual intercourse is often painful for both men and women. Fibromyalgia, musculoskeletal pain, constipation, irritable bowel syndrome, autoimmune diseases, depression, allergy and migraine are more common among these patients.

Reasons

Although it has been investigated seriously in many aspects, it is not known exactly why this disease occurs. However, the generally accepted view is that this disease does not have a single cause, on the contrary, it is a syndrome in which many immunological, allergic, neurovascular, infectious, even environmental and genetic factors play a role.

Diagnosis

The diagnosis of the disease is made by eliminating other diseases with similar symptoms. The following tests and steps are used to do this.

  • Detailed Story
  • Physical examination
  • Urine Analysis and Culture
  • Inquiry Forms and Chart for Urination Frequency
  • Potassium Sensitivity (Parsons) Test
  • Urodynamics
  • Cystoscopy

Treatment

  1. Stage Treatment: Conservative Approach

– Informing the patient about his/her illness

– Lifestyle changes: avoiding stress, exercising, learning to relax the pelvic floor muscles, warm shower baths, etc.

– Diet: It is known that especially citrus fruits such as onion, tomato, legumes, banana, apple, apricot, orange, tangerine and lemon, peach, nectarine, yoghurt, mayonnaise, ketchup, mustard, and especially spicy dishes, vinegar, some salad dressings, artificial sweeteners, beverages containing alcohol or caffeine such as coffee and colas, some fruit juices and teas increase the complaints of patients. It will be useful to try these individually and remove those who increase the complaints from the diet.

  1. Stage Treatment: Medication

Oral: Amitriptyline, Pentosan Polysulphate Sodium (PPS) and Antihistamines are the most commonly used oral drugs and recommended in European Urology Guidelines.

Administered into Bladder: Lidocaine + Sodium Bicarbonate, Hyaluronic Acid, Chondroitin Sulphate, Pentosan Polysulphate Sodium (PPS) and Heparin are used for this purpose.

  1. Stage Treatment: Cystoscopy + Hydrodistension and Resection of Hunner Ulcers
  1. Stage Treatment: Intrabladder Botox Application and Sacral Neuromodulation
  1. Stage Treatment: Cyclosporine A and Intramural Onabotilinum Toxin A injections.
  1. Stage Treatment: Urinary Diversion + Cystectomy

NOTE: The page content is for informational purposes only, please consult your doctor for diagnosis and treatment.