Interstitial cystitis (in-ter-stish-uhl sĭ-stī’tĭs), or as we call it, IC, is a bladder condition that usually consists of multiple symptoms. Most IC patients have recurring pelvic pain, pressure, or discomfort in the bladder and pelvic region, and urinary frequency (needing to go often) and urgency (feeling a strong need to go). IC may also be referred to as painful bladder syndrome (PBS), bladder pain syndrome (BPS), and chronic pelvic pain.
Pain is the hallmark symptom, particularly as the bladder fills with urine. Pain can also occur in the urethra, vulva, vagina, testicles, rectum and/or throughout the pelvis. Urinary frequency is found in 92% of patients with IC/BPS. Urgency is also common. IC patients struggling with urgency often rush to the restroom to avoid and/or reduce pain. In contrast, overactive bladder (OAB) patients struggling with urgency run to the restroom not to reduce discomfort but to avoid leakage and/or becoming incontinent. It’s not unusual for patients to struggle with sleep due to a constant urge to urinate (nocturia). Sexual intercourse may also provoke pain and discomfort (dyspareunia).
Twenty-five years ago it was believed that BPS/IC did not exist in India and it was a disease predominantly present in Western world. Symptoms of BPS/IC and tuberculosis are more or less same and as tuberculosis is common in India most of the patients of BPS/IC were diagnosed and treated as tuberculosis. Now in 2016 it is well established that PBS/ IC is not uncommon in India and it is estimated that there are more than 1.25 million patients with BPS/IC.
In Indian patients the presentation is more or less same as the rest of the world but a large percentage have obstructive symptoms and unusual urinary symptoms. Anal discomfort is also common. BPS/IC is not considered to be a clinical disease as it is difficult to rule out all differential diagnosis only from history. Hunner’s lesion is very rare. Cystoscopy with hydro distension, oral therapy, intravesical therapy and surgical therapy form the back bone of management. It is difficult to know which treatment is best for a given patient. A staged protocol is followed and all the treatment modalities are applied to the patients in a sequential fashion—starting from the non-invasive to more invasive.
To know more visit Interstitial Cystitis Association and Interstitial Cystitis Network