chronic, painful bladder condition of uncertain etiology.
| Epidemiology | • More common in women especially if >40 • Associated with psychiatric & pain disorders (eg, fibromyalgia) | | --- | --- | | Clinical presentation | • Bladder pain with filling, relief with voiding • ↑ Urinary frequency, urgency BUT NO INCONTIENENCE • Dyspareunia • Symptoms are gradual and worsen over months | | Associated with | • Other chronic pain conditions (eg, fibromyalgia, endometriosis, IBS) • Sexual dysfunction • Psychiatric illness (eg, depression, anxiety). | | Diagnosis (clinical) | • Bladder pain with no other cause for ≥6 weeks • Normal urinalysis to exclude other conditions like cystitis • Post void residual exclude other conditions like urinary obstruction • STD screen | | Treatment | • Not curative, focus is on improving quality of life • Behavioral modification (bladder training, fluid management) , avoidance of triggers (eg, caffeine, alcohol, artificial sweeteners), physical therapy • Amitriptyline, pentosan polysulfate sodium • Analgesics for acute exacerbations |
those with worsening symptoms may require an increased dose
new-onset pain with urination (ie, dysuria) is atypical for interstitial cystitis and requires evaluation for other disorders