Interstitial Cystitis

Also called painful bladder syndrome, interstitial cystitis (IC) is a condition that results in recurring discomfort or pain in the bladder and pelvic region. The multidisciplinary team at the Section of Urogynecology at Loma Linda University Medical Center specializes in the treatment of complex urogynecological conditions like interstitial cystitis.

Interstitial Cystitis Symptoms

Of the estimated 1.3 million Americans with IC, more than 1 million are women. Symptoms may include:

  • Mild discomfort, pressure, tenderness or intense pain in the bladder and pelvic area
  • Urgent or frequent need to urinate
  • Intense discomfort when the bladder fills and some relief with emptying
  • Throbbing pelvic pain after sexual intercourse.

A woman may also have had multiple diagnoses and treatments for urinary tract infection when in fact all tests (urine cultures) have been normal. Women sufferers may find their symptoms often get worse during menstruation.

Causes of Interstitial Cystitis

The causes of IC are not clearly understood. One common theory is that there is absence or break in a protective surface layer of the bladder. Currently, this theory is the basis of many of our most effective treatments. Many women with IC may also suffer from other conditions such as irritable bowel syndrome and fibromyalgia. Some research indicates that IC may be part of a more general condition that causes inflammation in various organs in the body. Scientists are also now exploring a possible genetic connection that may contribute to the condition.

Available Treatments for Interstitial Cystitis

Since there is no cure for interstitial cystitis, treatments are aimed at relieving the symptoms that accompany the condition. An oral medication cocktail can relieve symptoms in many women. Others find relief through bladder instillation of a liquid medication cocktail that includes Heparin, which coats the bladder wall and provides a protective layer. Hydrodistension of the bladder not only helps in diagnosis, it is often therapeutic.

Sacral nerve modulation, also called Interstim or sacral neuromodulation, has shown to be an effective treatment for IC, although the reasons are not fully understood. Current theories suggest that sacral nerve modulation, which sends electrical impulses to the nerves, may interrupt abnormal pain signals that travel between the bladder, pelvic floor and the brain.

A multidisciplinary treatment approach may be necessary, during which a urogynecologist and another specialist work together. A colorectal surgeon can treat complex colorectal diseases. A gastroenterologist may help with irritable bowel issues, and an internist or rheumatologist may help with autoimmune issues. A pelvic floor physical therapist can help via exercise, giving myofascial massage and providing transcutaneous electrical nerve stimulation (TENS) therapy.

A psychologist or therapist can assist with stress reduction and meditation, and complementary medicine such as acupuncture can help relieve pain. Surgery is an option if more conservative treatments have failed and the pain is disabling. Many approaches and techniques are used, and the medical team at Loma Linda University Medical Center will suggest the best course of action for each patient.