WHAT ARE THE SYMPTOMS?
- Frequent urination
- Nocturia (waking up from sleep to urinate)
- Urgency (unpleasant, painful, and urgent sensation to urinate)
- Pain that worsens as the bladder fills and improves after emptying it
Many patients are treated as if they have bacterial cystitis, leading to the inappropriate and ineffective use of antibiotics, while urine tests do not indicate an infection.
WHAT IS THE INITIAL APPROACH - WHAT CAN I DO ON MY OWN?
Urine examination is essential for distinguishing IC/BPS from bacterial cystitis. Atypical microorganisms, such as Chlamydia, should also be checked, especially in sexually active individuals. However, a proper diagnosis requires the expertise of your Urologist.
Adequate fluid intake of up to 2 liters per day, without excess, is recommended to avoid intense frequent urination. Additionally, you can identify foods or beverages that worsen your symptoms. Stressful situations can exacerbate the condition, so avoiding them can be beneficial.
When behavioral therapy does not yield the desired results, specialized treatments should be sought.
MORE SPECIFIC TREATMENTS
Your urologist will advise you on the appropriate treatment, which is usually pharmaceutical. It is essential to know that there is no sufficient scientific evidence to determine the superiority of one treatment over another, and often the side effects of these treatments lead to their discontinuation. Moreover, expectations of treatment effectiveness should be approached with caution.
Amitriptyline is one of the drugs that can be used orally, up to 100mg, while intravesical sodium hyaluronate injections may have different effectiveness. The use of analgesics in any form should be approached with great caution due to the increased risk of side effects. Pelvic floor physiotherapy is a useful alternative.
Regardless of the chosen treatment, patient follow-up should be thorough and long-term.
ARE THERE SPECIFIC TESTS FOR DIAGNOSIS?
Your urologist will guide you through the examination, depending on your symptoms. So far, there have been no tests that can accurately confirm or exclude the diagnosis. Ultrasound of the bladder, urodynamic testing, and magnetic resonance imaging of the lower abdomen, combined with urine test findings, might provide a more accurate conclusion, but still with limited accuracy.
Cystoscopy, a procedure where a flexible instrument with an integrated camera is inserted through the urethra into the bladder, plays a prominent role in the final diagnosis. Even in cases of patients with IC/BPS, the examination may appear normal, and the experience of your urologist is essential for its evaluation.
Alternatively, the examination can be performed with a rigid instrument in an operating room under anesthesia, allowing distension of the bladder (hydrodistention) and the possibility of taking biopsies. In these cases, the results of the biopsy examined by a pathologist can provide a more accurate diagnosis of the disease. During hydrodistention, it is possible to reveal lesions on the bladder wall, known as Hunner's ulcers, and minor bleeding without clinical significance can occur.
WHERE SHOULD I SEEK HELP?
Since IC/BPS mostly affects women, the first specialty involved is usually gynecology. The collaboration of gynecologists and urologists is required for diagnosis and inclusion in treatment plans, while the involvement of a pain management center and specialized physiotherapists is often necessary for comprehensive management of IC/BPS.
For a more comprehensive approach to IC/BPS, you are recommended to be referred to specialized centers.
