Interstitial cystitis: painful bladder syndrome

Although interstitial cystitis is a fairly uncommon cause of cystitis in patients, it is one that is frequently misdiagnosed as either bacterial, urological or gynecological in origin. Interstitial cystitis is a chronic inflammatory condition of unknown etiology, involving the bladder wall. The patient is usually a middle-aged female with presenting symptoms of 1) subacute development of pain on bladder filling, 2) urinary frequency unrelieved at night and 3) urgency. Patients complain of a varying degree of symptoms over several months or years without complete relief at any time, regardless of antibiotic treatment. The urine culture is negative and the only physical examination finding may be some urethral/vaginal tenderness. With careful attention to the symptom complex and accurate diagnostic testing, the diagnosis can be confirmed. This article summarizes the etiology, signs and symptoms, diagnostic criteria and treatment modalities for interstitial cystitis; patient-counseling suggestions are provided.