When almost forgotten, it recurs: Interstitial Cystitis
In 2021, over 1.57 million patients sought medical attention for cystitis.Approximately 5% to 20% of South Korea’s population has experienced interstitial cystitis, marked by chronic symptoms including frequent urination, residual urine, and pelvic pain. Around 2% report severe pain.
Interstitial cystitis vs Bacterial cystitis vs Overactive bladder
Interstitial cystitis is diagnosed only after thorough diagnostic tests have eliminated other potential conditions.
Treatment begins with dietary management and conservative therapies
||Pain occurs when the bladder is filled
||Pain occurs when urinating
||Difficulty in retaining urine
|Frequent urge to urinate
||- Urinalysis shows either normal or detects hematuria
- Capillary bleeding
- Hunner’s lesions
- Reduced bladder capacity
Detection of inflammation and bacteria in a urinalysis
||Normal urinalysis results
||Various drug and surgical treatments for symptom relief
||Pharmacotherapy, including antimuscarinics and beta-blockers
Maintaining a regular lifestyle and adhering to dietary guidelines are essential for interstitial cystitis treatment. It is advisable to avoid beverages containing caffeine and alcohol, as well as foods with spicy or stimulating seasonings, as these can irritate the bladder when excreted in urine. Instead, it is beneficial to focus on consuming fruits and vegetables.
Bladder hydrodistension and augmentation as surgical treatments
In addition to dietary management, a combination of bladder training techniques for enhancing bladder capacity and drug therapy is utilized to reduce pain and frequent urination. Depending on the severity of symptoms, medications may be administered directly into the bladder to strengthen its mucosal layer.
In cases where there is no improvement despite dietary management and medication, surgical interventions may be considered. Bladder hydrodistension, which uses water pressure to expand the bladder, is commonly the initial treatment for interstitial cystitis. While it can temporarily relieve symptoms, it is not a permanent solution and may necessitate repeat surgeries.
When characteristic findings like Hunner’s lesions are identified within the bladder, they can be cauterized or excised using endoscopy. For refractory interstitial cystitis, which severely impacts daily life with severe pain, bladder augmentation may be recommended to increase bladder capacity by removing a portion of the bladder and using a section of the intestine.