Have you been experiencing pain in or around your bladder, having urgency or frequency with urination, or do you have the sensation of pressure and discomfort in your bladder? Many of these symptoms in the absence of any identifiable cause can be linked to a diagnosis of Interstitial Cystitis, or IC. The condition has also been called painful bladder syndrome, hypersensitive bladder, or bladder pain syndrome.
Many conditions can mimic the symptoms of IC. This is why it is important to see your provider to rule out possible urinary tract infections, bladder cancers, and bladder dysfunction or pelvic floor dysfunction. Diagnosis of IC is divided into two categories, those with ulcers on the bladder and those with no evidence of bladder pathology, such as an ulcer. Bladder ulcers are called Hunner’s lesions (ulcerations) or glomerulations (hemorrhages).
Symptoms of IC can include:
Lower abdominal pain or pelvic pain
Pressure or pain with bladder filling
Frequent urination
Small amounts of urine with urination
Tests Your Provider May Perform:
Urine sample-your provider will test your urine for signs of infection
Cystoscopy with and without distension (stretching)-a camera is used to look inside the bladder. With distension, the bladder is filled to capacity to identify small lesions or injuries which can not be viewed when the bladder is in a more relaxed position.
Biopsy of bladder and urethra-tissue from the bladder is taken and studied
Treatment Plan
| Bladder pain syndromes and IC without ulcers | Interstitial Cystitis with ulcers |
First line treatment | Elimination diet and stress management | Bladder directed therapies such as cauterization |
Second line treatment | Pelvic floor physical therapy, oral medications, bladder instillations | Pelvic floor physical therapy |
Third line treatment | Nerve blocks and trigger point injections | Nerve blocks and trigger point injections |
Fourth line treatment | Botox | Botox |
Fifth line treatment | Nerve stimulation | Suppress the immune system to suppress inflammation |
Next line treatment | | Nerve stimulation |
Last treatment option | | Reconstructive surgery |
Complimentary therapies | Acupuncture, massage, guided imagery, and psychological therapies | |
Pelvic Floor Physical Therapy
Pelvic floor physical therapy is a secondary focus with interstitial cystitis without ulcers. These individuals often demonstrate multiple trigger points in muscles, tight tender muscles and connective tissue in their abdomen, groin, thighs, and buttocks. Pelvic floor dysfunction is very common with this diagnosis.
At The Fit Pelvis, we offer individualized and specialized treatment for pelvic floor dysfunction, bladder and bowel dysfunction, and pelvic pain. If you are interested in learning more, please visit thefitpelvis.com for more information.