What is Interstitial Cystitis?

Interstitial Cystitis (IC), also known as Bladder Pain Syndrome (BPS), is a chronic condition characterized by recurring discomfort or pain in the bladder and surrounding pelvic region. Unlike typical urinary tract infections, IC is not caused by bacteria and does not respond to antibiotics.

The condition affects the bladder wall, potentially causing inflammation and scarring. This can lead to a stiff, less elastic bladder that cannot hold as much urine as a healthy bladder.

IC/BPS affects millions of people, with women being more commonly affected than men. The exact cause remains unknown, but it is believed to involve a combination of factors, including defects in the bladder's protective lining, immune system dysfunction, and increased nerve sensitivity.

IC or recurrent infection?

IC is frequently mistaken for recurrent urinary tract infections. If your urine cultures keep coming back negative and antibiotics don't help, IC may be the cause — see our guide on recurrent UTIs vs interstitial cystitis.

Common Symptoms

Urinary Symptoms

  • Frequent urination (up to 60 times per day in severe cases)
  • Urgent need to urinate
  • Pain or pressure in the bladder area
  • Pain during bladder filling, often relieved by emptying
  • Feeling like the bladder is still full after urinating

Pain & Discomfort

  • Pelvic pain that may worsen as the bladder fills
  • Pain during or after intercourse
  • Chronic pain in the perineum
  • Discomfort that may come and go in flares

Broader Impact on Daily Life

  • Sleep disruption from nighttime urination and discomfort
  • Sexual dysfunction
  • Reduced overall quality of life
  • Emotional stress, anxiety, and depression
  • Impact on work and daily activities

Diagnosis Process

Diagnosing IC requires a comprehensive evaluation, as there is no single definitive test. Our approach includes:

  • Medical History: Detailed review of symptoms, duration, and triggers
  • Physical Examination: Pelvic exam to assess tenderness and rule out other conditions
  • Urine Tests: To exclude infections and other urinary tract problems
  • Bladder Diary: Tracking urination patterns and fluid intake
  • Cystoscopy: Direct visualization of the bladder interior to identify inflammation or lesions when indicated
  • Urodynamics: Testing how the bladder functions during filling and emptying
  • Potassium Sensitivity Test: May be used in some cases to evaluate bladder wall integrity

Treatment Options

IC is managed with a stepwise plan, usually starting with conservative measures and adding advanced therapies as needed.

Conservative Treatments

Advanced Treatments

  • Oral medications (amitriptyline and other antidepressants, pentosan polysulfate)
  • Bladder instillations — medication placed directly into the bladder (e.g., DMSO, heparin, lidocaine)
  • Nerve stimulation therapies
  • Hydrodistension procedures
  • Botulinum toxin injections
  • Surgical options for severe, refractory cases

Living with IC

While IC is a chronic condition, many patients find significant relief through proper treatment and lifestyle modifications. Key strategies include:

  • Dietary Management: Identifying and avoiding foods that trigger symptoms
  • Stress Reduction: Managing stress through relaxation techniques, exercise, and support
  • Regular Follow-up: Working closely with your healthcare team to adjust treatments over time
  • Support Networks: Connecting with others and support groups who understand the condition

Our team at Advanced Urology specializes in comprehensive IC management, offering both traditional and innovative treatment approaches tailored to each patient's unique needs. With the right combination of therapies, most people with IC/BPS achieve meaningful improvement in their symptoms and quality of life.