Interstitial cystitis. An overlooked cause of pelvic pain

Interstitial cystitis is a disease primarily of young and middle-aged women that is characterized by pelvic pain, urinary frequency, and dyspareunia. Its cause is unknown, but defects in the protective glycosaminoglycan layer of the bladder mucosa may be responsible. The diagnosis is mainly one of exclusion. Cystoscopy reveals characteristic glomerulations in the bladder mucosa. Of the available treatments, the most common are intermittent hydrodilation of the bladder and intermittent intravesical instillation of dimethyl sulfoxide. Other methods and medications are currently under investigation. Although interstitial cystitis is uncommon, its potentially devastating effects may be modified or even averted if primary care physicians are familiar with its presentation and maintain a high index of suspicion.