What is Interstitial Cystitis?

Interstitial Cystitis (IC) / Painful Bladder Syndrome (PBS) is a chronic condition characterised by persistent bladder pain, pressure and urgency/frequency without infection. It is often under-diagnosed and significantly impairs quality of life. IC is more common in women (10:1 female:male ratio).

Symptoms

• Chronic pelvic or suprapubic pain — worse when the bladder fills, relieved by urination
• Urinary urgency and frequency (often 15–60 times/day in severe cases)
• Pain with sexual intercourse (dyspareunia)
• No bacterial infection on urine culture
• Often misdiagnosed as recurrent UTI

Diagnosis & Treatment

• Cystoscopy + hydrodistension under anaesthesia — to identify Hunner lesions and assess bladder capacity
• Potassium sensitivity test — to assess urothelial dysfunction
• Intravesical therapies — DMSO, heparin, hyaluronic acid (Cystistat) instillations
• Oral medications — pentosan polysulphate (PPS), amitriptyline, antihistamines
• Bladder hydrodistension — symptomatic improvement in 50–60% for 6–9 months
• Hunner lesion fulguration — for IC with specific bladder wall lesions; excellent response