Interstitial Cystitis Questions & Answers

Updated: Nov 02, 2017
  • Author: Eric S Rovner, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Questions & Answers

Overview

What is interstitial cystitis/bladder pain syndrome (IC/BPS)?

How does the International Continence Society define interstitial cystitis/bladder pain syndrome (IC/BPS)?

How is interstitial cystitis/bladder pain syndrome (IC/BPS) diagnosed?

What biomarkers have been identified for interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the most promising urinary biomarker for the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is goal of treatment for interstitial cystitis/bladder pain syndrome (IC/BPS)?

How is response to treatment assessed in interstitial cystitis/bladder pain syndrome (IC/BPS)?

When was the first description of interstitial cystitis/bladder pain syndrome (IC/BPS) published?

What is the pathophysiology of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of the transitional cell apical membrane of the bladder in the pathophysiology of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of histaminergic and muscarinic neurotransmitter receptors in the pathophysiology of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the subgroups of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the characteristics of ulcerative interstitial cystitis (IC)?

What are the characteristics of nonulcerative interstitial cystitis (IC)?

What are the possible etiologies of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What evidence supports a genetic role in the etiology of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which clinical history suggests interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which autoimmune conditions are associated with interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which psychiatric conditions are associated with interstitial cystitis/bladder pain syndrome (IC/BPS)?

Why is it difficult to determine the prevalence of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the prevalence of interstitial cystitis/bladder pain syndrome (IC/BPS) in women in the US?

What is the global prevalence of interstitial cystitis/bladder pain syndrome (IC/BPS) in women?

Which patient groups is at highest risk for interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the prevalence of interstitial cystitis/bladder pain syndrome (IC/BPS) among men and children?

What is the prognosis of interstitial cystitis (IC)?

What is the response of interstitial cystitis/bladder pain syndrome (IC/BPS) to treatment?

How does interstitial cystitis/bladder pain syndrome (IC/BPS) affect quality of life?

How does education and counseling affect the prognosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which associations provide patient support for interstitial cystitis/bladder pain syndrome (IC/BPS)?

Where can patient information on interstitial cystitis/bladder pain syndrome (IC/BPS) be found?

Presentation

What is the typical presentation of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the symptoms of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the disease course of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the most prevalent feature of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which symptoms of interstitial cystitis/bladder pain syndrome (IC/BPS) can be reproduced urodynamically or with cystography?

What is the presentation of interstitial cystitis/bladder pain syndrome (IC/BPS) in men?

What are common comorbidities of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the significance of sleep difficulties in women with interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of questionnaires in the diagnosis of interstitial cystitis (IC)?

Which questionnaires have been validated for use in the evaluation of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the Pelvic Pain and Urgency/Frequency Patient Symptom Scale for interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which exams should be performed in the evaluation of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which physical findings may suggest diagnoses other than interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is included in the full exam of patients with suspected interstitial cystitis/bladder pain syndrome (IC/BPS)?

How is interstitial cystitis/bladder pain syndrome (IC/BPS) differentiated from provoked vestibulodynia disorder (PVD)?

How is provoked vestibulodynia disorder (PVD) treated?

Which physical findings are characteristic of interstitial cystitis/bladder pain syndrome (IC/BPS) in males?

What are the National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) diagnostic criteria for interstitial cystitis (IC)?

What are the cystoscopic diagnostic criteria for interstitial cystitis (IC)?

What are subjective symptoms of interstitial cystitis (IC)?

What are the diagnostic exclusion criteria for interstitial cystitis (IC)?

DDX

How is interstitial cystitis/bladder pain syndrome (IC/BPS) diagnosed?

What is needed for a diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the differential diagnoses of interstitial cystitis/bladder pain syndrome (IC/BPS) associated with urinary frequency, urgency, and/or pain?

What are the differential diagnoses of interstitial cystitis/bladder pain syndrome (IC/BPS) associated with infectious or inflammatory conditions?

What are the gynecologic conditions included in the differential diagnoses of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the urologic conditions included in the differential diagnoses of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the neurologic conditions included in the differential diagnoses of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which GI conditions are included in the differential diagnoses of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Workup

When is the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS) most often made?

What is the role of cystoscopy in the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of urodynamic evaluation in the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of imaging studies in the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which findings on MRI are characteristic of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of cystography and voiding cystourethrography in the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of urethral and vaginal culture in the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which assays are used in the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of expressed prostatic secretions for the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the most important diagnostic tool for assessing interstitial cystitis/bladder pain syndrome (IC/BPS)?

How is cystoscopy performed for the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

How are ulcers of bladder mucosa and areas with angiogenesis detected in the evaluation of interstitial cystitis/bladder pain syndrome (IC/BPS)?

How is diagnostic hydrodistention performed in the evaluation of interstitial cystitis/bladder pain syndrome (IC/BPS)?

How is hydrodistention performed in the evaluation of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which findings from hydrodistention indicate interstitial cystitis/bladder pain syndrome (IC/BPS)?

How is a finding of glomerulations characterized in interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the diagnostic significance of a finding of glomerulations in the evaluation of interstitial cystitis/bladder pain syndrome (IC/BPS)?

In which bladder conditions are glomerulations seen?

How does hydrodistention affect the symptom of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of biopsy in the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the pathognomonic histologic findings characteristic of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which histologic finding is diagnostic of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of potassium sensitivity testing in the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of urine studies in the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of urodynamic studies in the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Treatment

What are the challenges of treating interstitial cystitis/bladder pain syndrome (IC/BPS) in a primary care setting?

What is the treatment approach for interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the treatment options for interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of alternative, holistic, or complementary therapies in the treatment interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of counseling in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are behavioral treatment options for interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the duration of behavioral therapy for interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of diet in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which foods may be aggravating factors in interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of a food diary in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are theories for dietary exacerbations in interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which foods have been identified as least aggravating for patients with interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of medications in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the duration of drug treatment for interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of pentosan polysulfate sodium in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of amitriptyline in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of anticholinergic agents in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of cyclosporine in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of mycophenolate mofetil (MMF) in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of tanezumab in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of cimetidine in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the AUA treatment algorithm used for interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the treatment algorithm for interstitial cystitis/bladder pain syndrome (IC/BPS) in patients with significant voiding symptoms?

What is the role of pentosan polysulfate sodium in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

How is pain managed in patients with interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which agents are used for pain relief in interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of narcotics in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are nonpharmacologic options for pain relief in interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the treatment options for interstitial cystitis/bladder pain syndrome (IC/BPS) if medical therapy fails?

What is the role of intravesical therapy for interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of capsaicin in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of resiniferatoxin in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of hyaluronic acid in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the efficacy of hyaluronic acid in combination with hydrodistention for the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of chondroitin sulfate in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of intravesical bacillus Calmette-Guérin (BCG) in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of intravesical liposomes in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the use of hyperbaric oxygen in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of bladder hydrodistention in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the mechanism of action of hydrodistention for the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of surgery in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of sacral neuromodulation in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the efficacy of sacral neuromodulation in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the indications for sacral neuromodulation in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of pudendal nerve stimulation in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of botulinum toxin in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of intradetrusor onabotulinumtoxinA (OBA) in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the efficacy of intradetrusor onabotulinumtoxinA (OBA) for the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are potential mechanisms for the effectiveness of intradetrusor onabotulinumtoxinA (OBA) in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which surgical therapies are used rarely in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of urinary tract reconstruction or urinary diversion in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the role of diversion in the absence of cystectomy in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the limitations to reconstructive procedures for the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Guidelines

Which organizations have issued guidelines for the diagnosis and management of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the American Urological Association (AUA) recommendations for the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the Canadian Urological Association (CUA) recommendations for the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are additional Canadian Urological Association (CUA) recommendations for the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What do both the American Urological Association (AUA) and the Canadian Urological Association (CUA) recommend against for the diagnosis of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which guidelines include an algorithm for treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the American Urological Association (AUA) treatment guidelines for interstitial cystitis/bladder pain syndrome (IC/BPS)?

What is the American Urological Association (AUA) hierarchy for interstitial cystitis/bladder pain syndrome (IC/BPS) treatments?

What are the guidelines recommended first-line treatments for interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the CUA recommended dietary restrictions for the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the American Urological Association (AUA) second-line treatment recommendations for interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the Canadian Urological Association (CUA) second-line treatment recommendations for interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the American Urological Association (AUA) third-line treatment recommendations for interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the American Urological Association (AUA) fourth-line treatment recommendations for interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the Canadian Urological Association (CUA) third- and fourth-line treatment recommendations for interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are guidelines for the use of cyclosporine in interstitial cystitis/bladder pain syndrome (IC/BPS)?

What are the American Urological Association (AUA) recommendations for surgery to treat interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which treatments for interstitial cystitis/bladder pain syndrome (IC/BPS) are recommended against by the AUA?

Medications

Which medications are used in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Which medications in the drug class Anticoagulants, Hematologic are used in the treatment of Interstitial Cystitis?

Which medications in the drug class Antibacterials, Topical are used in the treatment of Interstitial Cystitis?

Which medications in the drug class Urologics, Other are used in the treatment of Interstitial Cystitis?

Which medications in the drug class Analgesics, Urinary are used in the treatment of Interstitial Cystitis?

Which medications in the drug class Antidepressants, TCAs are used in the treatment of Interstitial Cystitis?

Which medications in the drug class Antihistamines, 1st Generation are used in the treatment of Interstitial Cystitis?