Interstitial Cystitis: Symptoms and Signs

Interstitial cystitis (IC) is a chronic and debilitating disease of the urinary tract and bladder that affects approximately one million people. There is an inflamed and irritated bladder wall that leads to many bladder symptoms. The bladder wall of an IC patient will have stiffening and scarring of the bladder, less bladder capacity as a result of the scarring, small pinpoint bleeding on the bladder (glomerulations) and ulcers in the bladder lining (Hunner’s ulcers).

So much isn’t known about the illness, even though it has been around for a while now. This article deals with the signs and the symptoms of interstitial cystitis. A general guideline for interstitial cystitis is from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and although it has come under fire and scrutiny as it doesn’t incorporate all of the prevailing symptoms and has some things included as an exclusion that some people with IC do indeed have, it is meant as a oversee of the illness and not a conclusive.

NIDDK Research Definition of Interstitial Cystitis

Inclusion Criteria
1. Cystoscopy — glomerulations and/or classic Hunner’s ulcer.
2. Symptoms — bladder pain and/or bladder urgency.

Exclusion Criteria
1. Bladder capacity greater than 350cc on awake cystometry.
2. Absence of an intense urge to void with the bladder filled to 100cc during cystometry using a fill rate of 30-100cc/min.
3. Demonstration of phasic involuntary bladder contractions on cystometry using the fill rate described in number 2.
4. Duration of symptoms less than 9 months.
5. Absence of nocturia.
6. Symptoms relieved by antimicrobials, urinary antiseptics, anticholinergics, or antispasmodics.
7. Frequency of urination while awake of less than eight times a day.
8. Diagnosis of bacterial cystitis or prostatitis within a 3-month period.
9. Bladder or ureteral calculi.
10. Active genital herpes.
11. Uterine, cervical, , or urethral cancer.
12. Urethral diverticulum.
13. Cyclophosphamide or any type of chemical cystitis.
14. Tuberculous cystitis.
15. Radiation cystitis.
16. Benign or malignant bladder tumors.
17. Vaginitis.
18. Age less than 18 years.

This is a research definition only (for inclusion of patients in clinical trials) and is not necessarily applicable to diagnoses made in clinical practice. The major difference in the less stringent Interstitial Cystitis Database (ICDB) inclusion criteria for the diagnosis of IC is that cystoscopy (and its related diagnostic criteria) is an optional criterion for entry into the ICDB study. The rigid urodynamic exclusion criteria in the NIDDK definition do not exclude patients from an ICDB IC diagnosis.

The symptoms and signs of interstitial cystitis are varied and not every IC patient will have all of them. It is a difficult illness to pinpoint and this is meant only as a guideline to some of the symptoms that the interstitial cystitis patient may have.

1. Pelvic and perineal pain and pressure.
2. Urinary frequency: over 8 times/day; average is 16 times/day; can be up to 60 times/day.
3. Nocturia (excess urination at night).
4. Urinary urgency: urge not relieved by voiding.
5. Over 9 months of symptoms.
6. Dyspareunia (painful ).
7. Hematuria (blood in urine).
8. Symptoms worsen during menstruation.
9. Diminished bladder capacity.
10. and scrotum pain and pressure.
11. Dysuria (pain on urination).
12. UTI (Urinary tract infection) symptoms that do not improve upon antibiotic treatment.

50% of IC patients will have pain while riding in a car or with any prolonged sitting function; 63% are unable to work full time. Perhaps the most staggering statistic of IC is that interstitial cystitis patients are 3-4 times more likely to commit suicide than those who do not have the illness and that they rank below kidney dialysis patients in quality of life. So please, if you have any of the above mentioned signs or symptoms, get to an urologist. This diagnosis takes approximately 7 years to receive, usually through trial and many errors. Get checked, get tested, and get back on tract with your life.

Article by Tina Samuels.