An Evening with Dr. Robert Moldwin
New, Emerging Therapies for Interstitial Cystitis
IC/PBS is a condition of increased bladder sensitivity. Its diagnosis is primarily made on the basis of typical symptoms and the lack of other significant bladder problems such as a bladder infection or cancer. IC/PBS is more common in women, but recent evidence suggests that the prevalence in men is much higher than previously thought.
The symptoms of IC/PBS may include:
- Urinary frequency. Small volumes are typically voided. Patients usually awaken at night to urinate.
- Urinary urgency. Patients usually need to seek bathroom facilities quickly due to mounting discomfort, not the sensation that they might leak urine.
- Pelvic pain or discomfort. This often changes as the bladder fills and empties.
Other problems frequently encountered by the IC/PBS patient include:
- Pain associated with sexual intercourse
- Symptoms worsened by various foods and beverages
- Other co-existing problems such as environmental allergies, irritable bowel syndrome, fibromyalgia, skin sensitivity, and vulvodynia (vulvar pain)
- Hesitation or interruption of the urine stream
- The sensation of needing to urinate almost immediately after urinating.
- Symptoms that vary with the menstrual cycle.
IC/PBS can be broken down into two major categories:
"Classic" disease. This form of IC/PBS is associated with visible inflammation of the bladder wall. Lesions called "Hunner's ulcers" or "Hunner's patches" can be seen when the bladder is examined. Only about 5% of all patients have this type of disease.
- "Non-classical" disease. Patients with this condition have many symptoms, but examination of the bladder surface shows no obvious inflammation. Most patients with IC/PBS have non-classical disease.