eMedicine Specialties > Urology > Interstitial Cystitis

Interstitial Cystitis: Follow-up

Author: Eric S Rovner, MD, Professor, Department of Urology, Medical University of South Carolina
Contributor Information and Disclosures

Updated: Nov 24, 2009

Outcome and Prognosis

Interstitial cystitis (IC) is a chronic condition with a variable course, which, unfortunately, responds poorly to treatment in many cases. The most important element in treating these patients is education and emotional support. Patients must understand that interstitial cystitis is characterized by intermittent periods of exacerbations and remissions. Periodic exacerbations are managed as they occur because no long-term therapy has been shown to prevent or delay recurrent episodes. Furthermore, even though only approximately 10% of patients present with classic (ulcerative) interstitial cystitis, no treatment to date has been shown to decrease disease progression; therefore, the purpose of treatment is to palliate and alleviate symptoms.

Future and Controversies

Diagnosing interstitial cystitis (IC) remains difficult even more than 100 years after it was described by Skene in 1887. No pathognomonic findings exist with regard to patient history, physical examination findings, laboratory findings, or cystoscopy findings. The exclusion of other clinical entities remains the foremost goal of the workup and evaluation of patients thought to have this condition.

A careful, complete, and empathetic history and physical examination are critical. Cystoscopy is an adjunctive, although important, study. The classic Hunner ulcer in the setting of a small-capacity bladder (ie, assessed under anesthesia) rarely confirms the diagnosis with certainty. Until interstitial cystitis is defined completely or a definitive marker becomes universally available, the diagnosis remains one of exclusion.

Studies at several centers are examining various soluble urinary and serum markers in patients with interstitial cystitis. The goals of this research include identifying the causative agent(s) or at least a marker for case identification and diagnosis. Alternatively, certain other soluble factors are being evaluated as potential surrogates of disease activity and response to therapy.

 
Acknowledgments

Ricardo Sanchez-Ortiz, MD, and Matthew Eskridge, MD, contributed to this manuscript on earlier versions.



More on Interstitial Cystitis

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Workup: Interstitial Cystitis
Treatment: Interstitial Cystitis
Follow-up: Interstitial Cystitis
References
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Further Reading

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Keywords

interstitial cystitis, IC, painful bladder syndrome, ulcerative interstitial cystitis, ulcerative IC, nonulcerative interstitial cystitis, nonulcerative IC, classic interstitial cystitis, classic IC, Messing-Stamey interstitial cystitis, Messing-Stamey IC, painful bladder disease complex, nonbacterial cystitis, chronic cystitis, pelvic pain, daytime urinary frequency, nighttime urinary frequency, urinary urgency, overflow incontinence, Hunner ulcer

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Contributor Information and Disclosures

Author

Eric S Rovner, MD, Professor, Department of Urology, Medical University of South Carolina
Eric S Rovner, MD is a member of the following medical societies: Alpha Omega Alpha, American Association of Clinical Urologists, American College of Surgeons, American Urological Association, International Continence Society, Société Internationale d'Urologie (International Society of Urology), and Society of Pelvic Reconstructive Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

CME Editor

J Stuart Wolf Jr, MD, FACS, David A Bloom Professor of Urology, Director of Division of Minimally Invasive Urology, Department of Urology, University of Michigan
J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology
Disclosure: Terumo Corporation Consulting fee Consulting; Gyrus-ACMI Honoraria Speaking and teaching

Chief Editor

Edward David Kim, MD, FACS, Professor of Surgery, Division of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center
Edward David Kim, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association, and Tennessee Medical Association
Disclosure: Lilly Consulting fee Consulting; Astellas Consulting fee Speaking and teaching; Indevus Consulting fee Speaking and teaching

 
 
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