Interstitial cystitis

(Painful bladder syndrome) is a chronic condition of cystitis that is characterized by bladder and pelvic pain with urinary frequency, urgency and nocturia in the absence of another identified cause for the symptoms. People who are showing the symptoms that lasts for more than 6 weeks, and do not have other urinary problems may have interstitial cystitis. Both sexes are vulnerable to interstitial cystitis, but most patients are women, with a mean age of 40 years.

Causes of interstitial cystitis

The causes of interstitial cystitis is unknown but it is thought to be neurogenic causes (sensory nervous system abnormalities), autoimmunity or increased epithelial permeability. Some combination of these and other factors that lead to a self-perpetuating process could result in chronic bladder pain and voiding dysfunction. On pathologic examination there are no pathognomonic findings.

Symptoms

The most common sign and symptoms of interstitial cystitis include:

• Pain with bladder filling that is relieved with urination.
• Urgency and frequency of urination.
• Nocturia
• Suprapubic pain or discomfort
• Pelvic pain (urethra, v*a*g*i*n*a, v*u*l*v*a, r*e*c*t*u*m)
• Pain in back and the lower abdomen

Treatment

There is no cure for interstitial cystitis, Treatment is about controlling the symptoms. Most patients achieve symptomatic relief from one of several approaches, including:

• Hydrodistention (This procedure is done to find out the cause of bladder pain)
• Amitriptyline is used as firstline medical therapy in patients with interstitial cystitis.
• Nifedipine and other calcium channel blockers have demonstrated some activity in patients with interstitial cystitis.
• Pentosan polysulfate sodium (Elmiron) is an oral medication that helps restore integrity to the epithelium of the bladder in somepatients.
• Intravesical instillation of dimethyl sulfoxide (DMSO) and heparin.
• Transcutaneous electric nerve stimulation (TENS) and acupuncture.

Surgery (Surgical therapy for interstitial cystitis should be considered only as a last option).