Interstitial cystitis (in-tur-STISH-ul sis-TIE-tis) — also called painful bladder syndrome — is a chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain. The pain ranges from mild discomfort to severe.
Your bladder is a hollow, muscular organ that stores urine. The bladder expands until it’s full and then signals your brain that it’s time to urinate, communicating through the pelvic nerves. This creates the urge to urinate for most people.
Symptoms. The signs and symptoms of interstitial cystitis vary from person to person. If you have interstitial cystitis, your symptoms may also vary over time, periodically flaring in response to common triggers, such as menstruation, sitting for a long time, stress, exercise and sexual activity. Interstitial cystitis signs and symptoms include:
Pain in your pelvis or between the vagina and anus in women
Pain between the scrotum and anus in men (perineum)
Chronic pelvic pain
A persistent, urgent need to urinate
Frequent urination, often of small amounts, throughout the day and night (up to 60 times a day)
Causes. The exact cause of interstitial cystitis isn’t known, but it’s likely that many factors contribute. For instance, people with interstitial cystitis may also have a defect in the protective lining (epithelium) of the bladder. A leak in the epithelium may allow toxic substances in urine to irritate your bladder wall. Other possible but unproven contributing factors include an autoimmune reaction, heredity, infection or allergy.
Treatment. No simple treatment eliminates the signs and symptoms of interstitial cystitis, and no one treatment works for everyone. You may need to try various treatments or combinations of treatments before you find an approach that relieves your symptoms:
Physical therapy. Working with a physical therapist may relieve pelvic pain associated with muscle tenderness, restrictive connective tissue or muscle abnormalities in your pelvic floor.
Bladder distention. Some people notice a temporary improvement in symptoms after cystoscopy with bladder distention. Bladder distention is the stretching of the bladder with water. If you have long-term improvement, the procedure may be repeated.
Medications instilled into the bladder. In bladder instillation, your doctor places the prescription medication dimethyl sulfoxide (Rimso-50) into your bladder through a thin, flexible tube (catheter) inserted through the urethra.
Surgery. Doctors rarely use surgery to treat interstitial cystitis because removing the bladder doesn’t relieve pain and can lead to other complications.