Interstitial cystitis (IC) is a painful condition of the bladder and surrounding pelvic region. Symptoms vary from case to case and even in the same individual. Symptoms can include an urge to urinate and an increased need to urinate. Pain may change in intensity as the bladder fills or empties. Women's symptoms often worsen during menstruation. Pain may accompany sexual intercourse. Because IC symptoms vary so much, researchers believe that IC is not a single disease but results from several different diseases. Scientists have begun to use the term painful bladder syndrome (PBS) to describe painful urinary conditions that do not strictly meet the definition of IC. The term IC/PBS is used to describe painful urinary conditions that cannot be attributed to an identifiable cause such as infection or bladder stones. IC/PBS is much more common in women than in men, with 90% of sufferers being women.

Some of the symptoms of IC/PBS resemble those of bacterial infection, but tests do not reveal any organisms in the urine. Patients with IC/PBS do not improve with antibiotic therapy. The cause of IC/PBS is not known. Researchers have identified a substance found in the urine of people with IC/PBS known as antiproliferative factor (APF) which appears to block the normal growth of cells that line the inside wall of the bladder. It is hoped that further understanding of the role of APF in IC/PBS may lead to learning the causes of the disease and more effective treatments.

Diagnosis of IC/PBS involves eliminating other diseases that cause similar symptoms, including urinary tract infections and bladder cancer in both sexes and prostatitis in men. Tests that are used to rule out other diseases include urinalysis, urine culture, cystoscopy, biopsy of the bladder wall, distention of the bladder, urine cytology, and examination of prostate secretions.

There is no cure for IC/PBS. Responses to available treatments vary from person to person. Symptoms may disappear without explanation (such as a change in diet). Symptoms may reappear unexplained after days, weeks, months or even years. Current treatments are aimed at relieving symptoms. Pentosan polysulfate sodium (Elmiron) is the first drug approved by the FDA to treat IC/PBS. It is not known exactly how it works, but it is theorized that it repairs defects in the lining of the wall of the bladder. Elmiron is given at 100 mg three times daily. Patients may not feel relief of symptoms for up to 4 months. Patients are asked to take the medication for at least 6 months to evaluate its effectiveness. Some patients find relief after bladder distention done as part of the diagnosis. Bladder irrigation with a DMSO solution is another FDA-approved treatment. Treatments are given every week or two for 6- to 8-week cycles. Most people who get relief from DMSO treatment notice improvement in symptoms 3 to 4 weeks after the first 6- to 8-week treatment cycle. Various surgical treatments up to removal of the bladder are used for people in whom all other treatments have failed and the pain is disabling.

Interstitial cystitis is a poorly understood disease that affects primarily women. It causes a spectrum of painful symptoms that range from irritating to disabling. The cause is not known and there is no cure. Treatments have limited effectiveness and require weeks to months to evaluate. Research is aimed at identifying the cause, which will hopefully result in better treatments.

Reference: http://kidney.niddk.nih.gov/kudiseases/pubs/interstitialcystitis/index.htm.

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