When almost forgotten, it recurs: Interstitial Cystitis 2023.11.09

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.

Interstitial cystitis Bacterial cystitis Overactive bladder
Symptom Pain occurs when the bladder is filled Pain occurs when urinating Difficulty in retaining urine
Frequent urge to urinate
Characteristics - 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
Treatment Various drug and surgical treatments for symptom relief Antibiotic therapy Pharmacotherapy, including antimuscarinics and beta-blockers

Treatment begins with dietary management and conservative therapies

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.
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.

Bladder hydrodistension and augmentation as surgical treatments

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.

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