Urology Practice of James A. Lugg, MD, FACS; John F. Bryant, MD; Douglas Harris, DO; Donald Tardiff, PA-C

Cheyenne Urological
Patient Services
  Enlarged Prostate/
    Prostate Obstruction
  Erectile Dysfunction
  Kidney Stones
  No-Scalpel Vasectomy
  Vasectomy Reversal
  Interstitial Cystitis
  Simple Cystitis
  Urinary Incontinence
  Infertility
Patient Information
Patient Services
Patient Services

Interstitial Cystitis (IC)
(Painful Bladder)
 
What is Interstitial Cystitis?

Interstitial Cystitis is a chronic and painful condition of the bladder. People with IC have a bladder wall that is tender and easily irritated, leading to uncomfortable symptoms. If you have this condition, you're not alone. Thousands of people (mostly women, but also some men) are affected by IC. Although IC currently has no cure, the symptoms can be managed to help you feel better and live more comfortably.

Symptoms of IC

IC symptoms are similar to those of urinary tract infection. They include the following:

  • The frequent and urgent need to urinate
  • Pain or pressure in the bladder area, often relieve for a short time after urinating
  • Pain in the genitals or anus
  • Painful sexual intercourse
  • Symptoms may go away for a period of time (remission), but they often come back again.
When You Have IC

The bladder stores urine (your body's liquid waste) until it's passed out of the body. What happens in the bladder to cause IC is not clear, but some changes have been observed. The protective lining that keeps urine away from the walls may stiffen and harden so the bladder can't expand to hold urine. During certain tests, pinpoints of bleeding (glomerulations) may be seen on the bladder wall. Rarely, a crater (called Hunner's ulcer) may also be found.

bladder problems
 
Possible Causes of IC

The cause of IC is still under debate, but possible causes include the following:

  • Damage to the protective bladder lining, allowing urine to irritate the bladder wall
  • Infection of the bladder
  • Allergic reaction in the bladder
  • Neurological (nerve) problems
  • Substances found in the urine that are irritating to the bladder
Your Evaluation

During your elevation, your doctor first tries to rule out the problems that may be causing your symptoms. Your doctor may begin by asking you questions about your symptoms and your medical history. Then he or she may check your abdomen and examine your genital area for signs of a problem. Certain tests may also be done.

Possible Tests
Tests that may be done to help diagnose IC rule out other problems including the following:
Testing for bladder problems
  • Lab Tests, such as urinalysis and urine culture, to test for infection
  • Cytology (examination of urine under a microscope) to rule out cancer
  • Urodynamic studies to test the workings of the bladder, such as how the bladder fills and empties
  • Cystospy, visual examination of the bladder, tolook for problems. The doctor looks at the bladder through a cystoscope, a tubelike instrument containing special lenses and a light. Cystoscopy is usually done in the hospital with general anesthesia so you are asleep. Your bladder is filled with fluid to stretch the walls, process called hydrodistention. A sample (biopsy) of bladder tissue may also be taken for examination.
Treatment Options

Many different types of treatment are available to help manage IC symptoms and relieve pain. Some may work well for one person and not for another, so several types of treatment may be tried before you and your doctor determine the plan that's best for you. Keep in touch with your doctor - tell him or her how each type of treatment is working. Treatment options include lifestyle changes, medications (taken by mouth or put directly into your bladder), biofeedback, electrical stimulation of the bladder, and rarely, surgery.

Lifestyle Changes
Making certain changes in the way you live may help you feel better. Try some of theses suggestions:
  • Avoid certain foods that may worsen your symptoms. These include alcohol, spicy food, chocolate, caffeine, citrus fruits and juices, tomatoes, and carbonated drinks.
  • Retrain your bladder if recommended by your doctor. This often involves holding urine in for longer periods to help stretch the bladder and increase the amount the bladder can hold.
  • Manage stress in your life. Stress doesn't cause IC, but it can make your symptoms worse. Ask your doctor about techniques to help you relax and relieve stress. Mediation, massage, and yoga are some possibilities. Exercise is an excellent way to help relieve stress. Walking and swimming are two good choices that may be comfortable enough for you to do regularly.
Oral Medications
Certain medications may be prescribed for you to help manage your symptoms. These include the following:
  • Pain medications for a short time to help ease discomfort
  • Antispasmodic medications to help relax the bladder muscles and decrease the need to urinate
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) and antihistamines to help reduce inflammation and relieve pain
  • Antidepressants in low doses to help relieve IC symptoms, perhaps by blocking pain receptors
Bladder Hydrodistention
Some patients have relief from symptoms for a time after bladder hydrodistention is done to diagnose IC. If this is true for you, your doctor may choose to repeat the hydrodistention procedure as a form of treatment.
 
Bladder Instillation
bladder instillation
Also called bladder wash or bath, bladder instillation may help relieve inflammation or repair the bladder's protective lining. During this treatment, the bladder is filled with medications using a slender tube called a catheter. One or more types of medication may be used. The medication is held inside the bladder for a period of time (usually from 15 to 30 minutes). Then the medication is urinated out or drained from the bladder through the catheter. Instillation treatments are often repeated several times over a period of two to three months.
 
Biofeedback
Bio Feedback

Biofeedback is a painless technique that can help you learn to control the movement of your bladder muscles. During biofeedback, sensors are placed on your abdomen. The sensors convert signals given off by your muscles into lines on a computer screen.


Electrical Stimulation
Stimulation of the area around your bladder with electrical signals may help relieve symptoms by blocking the nerve sensations to and from the bladder, by improving blood flow, or by strengthening the pelvic muscles. For this treatment (sometimes called TENS), wires are placed on the skin of the lower back abdomen. Mild electric pulses are then sent into the body for several minutes to hours. The therapy may be repeated one or more times daily, and may continue for several weeks to months.
 
Other Types of treatments
Certain other types of treatments may be tried to help relieve your IC symptoms. Therapeutic message of the abdominal muscles using heat or ice may help relieve the pain. Acupuncture, the therapeutic use of needles, may also help relieve pain in some cases.
 
Surgery
Surgery may be recommended for severe cases of IC that are not relieved by any other types of treatment. The results of surgery can be unpredictable. If your doctor recommends surgery, he or she can discuss the procedure's risks and benefits with you.
 
Getting Support

IC can leave you feeling depressed and alone, but there are resources you can turn to for support. Tell your doctor or nurse your feelings and concerns. Try to give your friends, family, and partner as much information as possible to help them understand your condition, and let them know what they can do to help you. You may also want to join a support group for people with IC. For more information about IC and IC support groups in your area, call the Interstitial Cystitis Association (ICA) at 1-800-ICA-1626.



 
 
Cheyenne Urological, P.C.
 
2301 House Street, Suite 500, Cheyenne, Wyoming 82001
(307) 635-4131 - info@cheyenneurological.com