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Interstitial cystitis

Interstitial cystitis (in-tur-STISH-ul sis-TIE-tis) — also called painful bladder syndrome — is a chronic condition in which you experience bladder pressure, bladder pain and sometimes pelvic pain, ranging from mild discomfort to severe pain.

Your bladder is a hollow, muscular organ that stores urine. The bladder expands until it's full and then signals your brain that it's time to urinate, communicating through the pelvic nerves. This creates the urge to urinate for most people. With interstitial cystitis, these signals get mixed up — you feel the need to urinate more often and with smaller volumes of urine than most people.

Interstitial cystitis most often affects women and can have a long-lasting impact on quality of life. Although there's no treatment that reliably eliminates interstitial cystitis, medications and other therapies may offer relief.

Symptoms Causes Risk factors Complications

The signs and symptoms of interstitial cystitis vary from person to person. If you have interstitial cystitis, your symptoms may also vary over time, periodically flaring in response to common triggers, such as menstruation, sitting for a long time, stress, exercise and sexual activity.

Interstitial cystitis signs and symptoms include:

  • Pain in your pelvis or between the vagina and anus in women or between the scrotum and anus in men (perineum).
  • Chronic pelvic pain.
  • A persistent, urgent need to urinate.
  • Frequent urination, often of small amounts, throughout the day and night. People with severe interstitial cystitis may urinate as often as 60 times a day.
  • Pain or discomfort while the bladder fills and relief after urinating.
  • Pain during sexual intercourse.

The severity of symptoms caused by interstitial cystitis often varies, and some people may experience periods during which symptoms disappear.

Although signs and symptoms of interstitial cystitis may resemble those of a chronic urinary tract infection, urine cultures are usually free of bacteria. -However, symptoms may worsen if a person with interstitial cystitis gets a urinary tract infection.

When to see a doctor

If you're experiencing chronic bladder pain or urinary urgency and frequency, contact your doctor.

The exact cause of interstitial cystitis isn't known, but it's likely that many factors are at play. For instance, people with interstitial cystitis may also have a defect in the protective lining (epithelium) of the bladder. A leak in the epithelium may allow toxic substances in urine to irritate your bladder wall.

Other suggested but unproven factors that may contribute to interstitial cystitis include an autoimmune reaction, heredity, infection or allergy.

These factors are associated with a higher risk of interstitial cystitis:

  • Your sex. Women are diagnosed with interstitial cystitis more often than men. Men can have nearly identical symptoms to those of interstitial cystitis, but they're more often associated with an inflammation of the prostate gland (prostatitis).
  • Your age. Most people with interstitial cystitis are diagnosed during their 30s or older.
  • Having a chronic pain disorder. Interstitial cystitis may be associated with having another chronic pain disorder, such as irritable bowel syndrome or fibromyalgia.

Interstitial cystitis can result in a number of complications, including:

  • Reduced bladder capacity. Interstitial cystitis can lead to a stiffening of the wall of your bladder and reduced bladder capacity, meaning your bladder holds less urine.
  • Lower quality of life. Frequent urination and pain may interfere with social activities, work and other activities of daily life.
  • Sexual intimacy problems. Frequent urination and pain may strain your personal relationships, and sexual intimacy is commonly affected.
  • Emotional troubles. The chronic pain and interrupted sleep associated with interstitial cystitis may cause emotional stress and can lead to depression.
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