Interstitial Cystitis/Painful Bladder

The exact cause of IC is still unknown. Researchers are investigating theories to understand the causes of IC and to determine appropriate treatments. These include:

• Defect in the bladder epithelium that allows irritating urine substances to penetrate the bladder
• Inflammatory cells releasing histamine and other chemicals
• Something in the urine that damages the bladder
• Change in nerves that carry bladder sensations
• Body's immune system attacks the bladder
• Substance in urine inhibits the growth of cells in the bladder epithelium
• Certain foods worsen symptoms, including citrus fruits, tomatoes, chocolate, coffee, and potassium-rich foods

The following are the most common symptoms of IC. However, each person may experience symptoms differently.

• Pain, in the urethra, lower abdomen, lower back, or the pelvic or perineal area
• Painful sexual intercourse
• Women may experience pain in the vulva or the vagina
• Men may feel pain in the scrotum, testicle or penis
• Frequent urination
• In most women, symptoms worsen during menstruation
• Stress may intensify symptoms

There is no definitive test to diagnose IC, and symptoms of IC mimic those of other urinary disorders. A variety of diagnostic tests and procedures may be necessary. In addition to a complete medical history and physical examination, these include:

• Urinalysis, a laboratory examination of urine for red and white blood cells, infection, or excessive protein.
• Urine culture and cytology
• Cystoscopy (also called cystourethroscopy), a small telescope passed through the urethra into the bladder to look at the urethra, prostate and bladder.
• Bladder wall biopsy, a procedure in which tissue samples are removed with a needle or during surgery for examination under a microscope.
• Laboratory examination of prostate secretions (in men)

There is no one specific way to diagnose IC and no cure for IC, making it difficult to treat. However, if a patient has typical symptoms and a negative urine examination shows no infection, IC is often suspected. Treatments focused on relieving symptoms may include:

• Bladder distension, a procedure aimed at increasing bladder capacity and interfering with pain signals that are being transmitted by the nerve cells in the bladder.
• Bladder instillation (also called a bladder wash or bath) fills the bladder with a solution for varying periods of time before being drained through a catheter.
• Transcutaneous electrical nerve stimulation (TENS) uses mild electric pulses either through wires placed on the lower back, or through special devices inserted into the vagina in women or rectum in men.
• Bladder training at designated times with relaxation techniques and distractions to maintain the schedule. Patients gradually lengthen time between scheduled voids.
• Medication
• Surgery
• Diet modification
• Not smoking
• Exercise

You will receive a thorough diagnostic evaluation and receive clinically-proven treatment by a board-certified urologist who specializes in interstitial cystitis. Our goal is to alleviate symptoms so you can return to every life. Appointments are confidential and private.

Brigham and Women's Hospital practices a multidisciplinary approach to patient care, routinely collaborating with colleagues in other medical specialties. If your urologist discovers that an underlying illness has contributed to your interstitial cystitis, you will be referred to an appropriate BWH physician for an evaluation.

Go to our online health library to learn more about urology diseases and tests.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.