Interstitial cystitis (IC), also called painful bladder syndrome, is a chronic condition in which the walls of the bladder are irritated and inflamed. It can be extremely painful and is one of the most common underlying causes of chronic pelvic pain.
While IC affects an estimated 4 to 12 million people in the U.S. regardless of age, gender or ethnicity, about 90% of those diagnosed with IC are women. It is most frequently diagnosed during a woman’s reproductive years.
The exact cause of IC isn’t known, but some possible causes include bladder trauma, pelvic floor muscle dysfunction, bacterial bladder infection (cystitis), or autoimmune disorder.
The symptoms of IC can vary from person to person, but generally include the need to urinate frequently (up to 60 times a day in severe cases), having to urinate urgently (which may be accompanied by pain, pressure or spasms), and pain in the lower abdomen, urethra, vagina, lower back or thighs. Pain and urinary symptoms often worsen before a woman’s period. Sexual intercourse can also be painful with IC.
Treatment for interstitial cystitis is complex and can include self-help measures and lifestyle changes, medications, specialized physical therapy, complementary therapies such as acupuncture, neuromodulation, Botox injections or surgery.
Diagnosing IC in women can be difficult because its symptoms can mimic or overlap with more common conditions such as urinary tract infections (UTIs), overactive bladder (OAB), pelvic floor disorders, pelvic congestion syndrome or endometriosis.
This is why it’s important to see a urogynecologist – a specialist in female pelvic medicine and reconstructive surgery – who deals specifically with issues such as IC. These specialists can provide an accurate, timely diagnosis and appropriate treatment.
Why Choose Cooper to Diagnose and Treat Interstitial Cystitis
Cooper University Health Care has a comprehensive urogynecology program that is on the forefront of care for interstitial cystitis in women. Our team of fellowship-trained urogynecologists offers a full range of today’s most advanced diagnostic and treatment services, provided in a caring, sensitive manner.
- We teach the next generation of urogynecologists through a respected fellowship program—testament to the high level of clinical expertise available here
- Our urogynecologists conduct leading-edge research, giving you access to the latest knowledge and advances in treating IC in women
Causes and Risk Factors for Interstitial Cystitis
The specific cause of IC is still not clearly known, but scientists have pinpointed several factors that may contribute to developing this condition:
- Trauma to the bladder, such as from pelvic surgery
- Pelvic floor muscle dysfunction
- Bladder overdistention (stretching) if you repeatedly go long periods without urinating
- Autoimmune disorder(s)
- Bacterial bladder infection (cystitis)
- Inflammation or hypersensitivity of the pelvic nerves (neurogenic inflammation)
- Damage to the spinal cord
Many scientists believe that a trigger, such as one or more of these factors, may damage the bladder or its lining. This damage allows particles in the urine to leak into the lining, leading to further damage to the bladder and causing chronic pain.
Normally, the bladder repairs itself, but in people with IC it doesn’t. Research shows that this might be because of a protein called APF (antiproliferative factor) that is produced by the cells of people with IC (but not in healthy people).
Symptoms of Interstitial Cystitis
IC symptoms are different from person to person and can even vary in the same person at different times. With IC, you may have some or all of these symptoms, and they may worsen around the time of your period:
- Urinary frequency: The urge to go a lot – as many as 60 times a day in severe cases
- Urinary urgency: The need to go immediately; pain, spasms or pressure may also accompany this urge
- Pain: You may feel ongoing pain in the lower abdomen or back, urethra, vagina or thighs, and frequently during sexual intercourse
Treating Interstitial Cystitis
While there currently is no cure for IC, there are many treatment options available to help relieve its symptoms. These include:
- Dietary changes such as avoiding alcohol, caffeine, citrus fruits, potassium-rich foods or other foods that can trigger symptoms
- Bladder retraining to learn to control the urge to urinate
- Specialized physical therapy techniques to help relax and lengthen tight muscles and release trigger points in the pelvic floor
- Alternative/complementary therapies such as acupuncture, Reiki, guided imagery or therapeutic massage
- Bladder instillations, in which medications to help ease IC symptoms are given via a small catheter inserted into the bladder
- Oral medications such as pain relievers, antidepressants, immunosuppressants, and antispasmodics
- Botox injections to relax the bladder muscles
- Neuromodulation, including the use of electrical nerve stimulators to alter pain signals
- Laser surgery to repair Hunner’s lesions (also called Hunner’s ulcers), which are areas of inflammation on the bladder wall found in 5% to 10% of people with IC
For most women with IC, a combination of various treatments is best. You may need to try a few different options before you find the optimal regimen to address your symptoms. Working with a specialist who understands the complex nature of IC can aid in this process.