I.C.
is a fairly common bladder condition that affects hundreds of thousands of women,
and a few thousand men as well. Why the predominance of women suffering from
this disorder is not known. This is one of the more frequently misdiagnosed
and underdiagnosed problems we see in urology. These patients often go for years
before the proper diagnosis is made, thus resulting in a substantial degree
of needless suffering. The hallmark symptoms are very similar to bladder infections….pain,
frequent urination, urgent urination, urinating at night, but usually accompanied
by pain in the pelvis, pain with sexual relations, and lack of response to antibiotics
or the typical medications used for urinary frequency and urgency such as Detrol
and Ditropan
The
diagnosis is often fairly obvious by the patient’s history if the physician
will just listen carefully. We have an I.C. questionnaire which helps as well.
Physical examination often reveals pain in the pelvic organs. The hallmark findings
are seen with an internal examination of the bladder (cystoscopy) done under
general anesthesia. In this setting the bladder is stretched somewhat with the
addition of water to the bladder the lining of the bladder changes in appearance,
clinching the diagnosis.
Often
the stretching described above is helpful, again for reasons we don’t fully
understand. There are medications, the most commonly used being Elmiron®.
This is a pill that is taken three times daily. The drug is used for long periods
of time, and frequently helps heal the bladder dramatically. There are other
medications that are helpful as well including medications put into the bladder
such as DMSO and heparin. Other medications taken by mouth can include amitrptyline
and hydroxoyzine. With continued effort between physician and patient, most
patients can enjoy improved bladder health.