Interstitial Cystitis Often Difficult to Diagnose, Treat

Q:  I'm a 37-year-old woman with a frustrating problem that has only been recently diagnosed. For years I've experienced urinary frequency, urgency and lower abdominal pain. After visits to several doctors over many years, I've been told I have interstitial cystitis and have started on a series of treatments that are showing some promise.

What is interstitial cystitis and why is it so hard to diagnose and treat?

A:  Your experience is not an uncommon one. Interstitial cystitis, or IC, is often difficult to diagnose and to treat satisfactorily. According to Russell Lawson, MD, former professor and chief of urology at the Medical College of Wisconsin, IC should be suspected when a patient has problems that mimic a urinary tract infection such as burning, frequency and urgency but with negative urine cultures and no response to antibiotic therapy.

At that point your physician should consider the possibility of IC and send you to a urologist for consultation. Urologists often use a procedure called cystoscopy to visualize the detrusor muscle and bladder wall. The detrusor muscle helps to empty the bladder and a cystoscopy will help to evaluate its current level of functioning. Key findings include the discovery of inflammation in the detrusor and a reduced bladder capacity.

Treatments for IC range from filling the bladder with a solution designed to reduce the inflammation and, occasionally, surgical procedures.

The cause of IC is not known, and it is not understood why 90% of those who experience it are women. Fortunately, Dr. Lawson notes, IC is receiving increased attention at the National Institutes of Health and is the object of increased research activity.

If you would like more information you may contact the Interstitial Cystitis Association at 110 N. Washington Ave. #340, Rockville, MD 20850. Phone: 1-800-HELP-ICA (1-800-435-7422). Website: www.ichelp.org.

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