Pelvic diseases are usually chronic, in that they tend to have been caused over a long period of time and have slowly turned painful over the years. One such condition is interstitial cystitis or painful bladder syndrome, which puts pressure on the bladder and thus causes pain in the bladder and the pelvic area. This pain can be minor, causing slight discomfort, to severe.
Understanding the disease
The normal functioning of the bladder, which is a muscular and hollow organ, is to store urine by expanding; once it is full, it sends signal to the brain indicating that it is time to urinate. This signal is communicated via the pelvic nerve, which creates an urge to urinate. When a person suffers from interstitial cystitis, these signals get mixed up and the person feels a frequent urge to urinate while only expelling a small volume of urine.
Women are more likely to suffer from this condition, which affects the overall quality of life.
The symptoms vary from one individual to another, but common symptoms include:
- Chronic pain in pelvic region
- Pain in perineum in men, between the scrotum and anus
- Pain in women between the vagina and anus or the pelvis
- Urgent and persistent urge to urinate
- Discomfort and pain experienced when the bladder fills as well as after urinating relief
- Frequent urination, close to 60 times throughout the morning and night, albeit urinating small quantities of urine each time
- Pain experienced during sexual intercourse
Over time, the symptoms flare up during common triggers, such as stress, sitting for a long time, menstruation, sexual activity, and exercise.
These symptoms are similar to those experienced during a urinary tract infection, but there is no infection in the body, thus making diagnosis difficult.
Causes and risk factors
Since the exact cause is unknown, it is assumed that many factors lead to interstitial cystitis. For instance, suffering from the condition may cause a defect in the epithelium of the bladder, thus making it leak and allowing toxic substances found in urine to irritate the bladder. Further complications due to interstitial cystitis include reduced capacity of the bladder, problems with sexual intimacy, lower quality of life, and emotional stress.
The risk factors include age (mostly diagnosed in the 30s), gender (women more susceptible), hair and skin color (red haired and fair skinned more susceptible), and those having previous chronic pain disorder.
Diagnosis and treatment
Diagnosis is done via pelvic exam, bladder diary and medical history, urine test, cystoscopy and biopsy, and urine cytology and potassium sensitivity test.
There is no single or simple treatment and thus combinations are applied, such as physical therapy and oral medications—for example, NSAIDS, tricyclic antidepressants, antihistamines, and pentosan polysulfate sodium. Nerve stimulation techniques, like sacral nerve stimulation or transcutaneous electrical nerve stimulation, may be carried out. Bladder distension and, rarely, surgery may also be performed. Alternative medicine and lifestyle changes are also suggested for treatment of interstitial cystitis.