Right. Interstitial cystitis is a condition where there is pain in the lower abdomen and problems passing urine.
It can occur in any age group, but is more common in the younger age group.
It's called bladder pain syndrome, and it can affect one's quality of life and their well-being.
When one has a urinary tract infection, there's usually a bacterial organism involved.
So when urine is actually sent to the lab and it's cultured, it comes up with a bacterial
infection and then one treats it with an antibiotic.
With interstitial cystitis, the urine comes back as negative.
Usually what happens is patients go to the general practitioner,
they have the symptoms of a urinary tract infection, but the GP sends urine to the lab, there is
no infection, and when this occurs a few times, then they get sent to the urologist, and then
a diagnosis of interstitial cystitis can be made.
The symptoms of interstitial cystitis vary.
These symptoms may be present all the time or may go in phases.
Usually, there's a strong desire to pass urine.
There can be burning when one passes urine and intense pain at times when one passes urine.
There is nocturia, which is getting up at night to pass urine
and also passing urine quite frequently during the day.
These symptoms are worse usually with periods, however, they go in phases,
and at times, one will find that symptoms are not as bad as other times.
The pathology of interstitial cystitis is complex, and therefore, there have been some
associations with other diseases like lupus, fibromyalgia, irritable bowel syndrome.
But it's very difficult to have just one type of person that one would say is more prone to interstitial cystitis.
It's a very complex disease and there are lots of research which
has gone into trying to find out the answers to these questions.
Unfortunately, there is no cure for interstitial cystitis, but there are a lot of treatments that can be tried.
No one treatment works for everyone, but there are a combination of treatments that can be used.
Lifestyle changes can help. These include making sure
one has an adequate fluid intake, stopping smoking, making sure that when one goes to
the toilet they empty completely.
Also, trying to reduce stress, as stress plays a very important
part in exacerbating episodes of interstitial cystitis.
There are various medications that one can use.
Patients are usually complaining of pain and therefore one wants to relieve the pain.
So various analgesics can be used to try and relieve this pain.
In addition, if one has increased frequency, passing urine quite a lot,
there are various medications that can be given to slow down the bladder so that
the patient is not passing urine as much. There are other treatments that can be given,
like putting in the bladder medications to ease the sort of soreness of the bladder.
And these preparations are hyaluronic acid or chondroitin sulphate, which is instilled
into the bladder over a period of time, and these preparations relieve the pain which
is usually the hallmark of interstitial cystitis. There are other supportive measures that may help.
Example: bladder retraining, doing pelvic floor exercises, and also one can do posterior
tibial nerve stimulation to try and reduce the urgency that these patients have.
Some of these treatments can reduce the amount of times that one is going to the toilet to actually pass urine.
Patients can have surgery and the surgery initially is looking inside
the bladder, and hydro distension, which is filling the bladder with water or saline and
this breaks down the ulcers in the bladder so that a new layer forms in the bladder and
this new layer does not have ulcers and therefore one finds that the bladder is much less painful.
I spoke about neuromodulation with posterior tibial nerve stimulation, but in some cases
the bladder becomes quite shrunken and patients may need to have the bladder removed.
That is a cystectomy. This of course only happens in extreme cases.